Society of Interventional Radiology opposes value-based care proposal

The Society of Interventional Radiology is voicing its opposition to a Medicare proposal aimed at moving IRs toward value-based care. 

CMS announced the initiative via the Medicare Physician Fee Schedule released on July 14. The feds are eyeing a new “Value Pathway” as part of the Merit-Based Incentive Payment System (MIPS). Under the proposal, Medicare would add an interventional radiology pathway, creating a new reporting framework for IRs as part of MIPS.

The Society of Interventional Radiology said this new specialty-specific payment pathway would seek to streamline reporting, focusing on measures relevant to IRs. 

“SIR previously sent a letter during the public comment period in January 2025 opposing this proposal and SIR remains concerned that the [MIPS Value Pathway] does not adequately reflect the diversity and highly subspecialized nature of IR,” the society said in a July 17 news update. “SIR believes the measure set is too narrow, making it difficult for many IRs to participate meaningfully without undue burden.”

The proposed payment pathway would include 24 measures from which interventional radiologists could select, including 11 tied to quality, 10 improvement activities and three related to costs. Of these, only three are “broadly applicable across the specialty,” SIR said. However, the remainder primarily apply to interventional radiologists subspecializing in stroke care, dialysis access, venous services and women’s health. 

“The exclusion of broadly applicable quality measures and the reliance on cost measures that do not fairly represent IR contributions further limit the feasibility of this [MIPS Value Pathway],” the society said in its news update. “SIR will provide CMS feedback through the comment process to ensure the MVP evolves into a more inclusive and practical framework that truly supports quality improvement and value-based care across the full spectrum of IR practice.”

The Merit-Based Incentive Payment System was established in 2017 to reward physician performance and help reduce healthcare costs. However, radiologists have faced challenges in the alternative pay model, as the specialty often does not interact directly with patients and there are relatively few imaging-related metrics. A study published in February found that small practices and individual radiologists are particularly disadvantaged in the payment program. 

The American College of Radiology also offered further details about the MIPS updates in its own breakdown of the proposed rule. SIR shared an analysis of the fee schedule in a separate post, noting there are 51 new payment codes and nine revisions related to interventional radiology.