The health care regulatory and economic environment is so complex that independent physician practices are challenged to comply, compete, and function as cornerstones of both health care and the communities they serve. Strategic Radiology aims not just to help its 37 member groups remain competitive—it strives to influence how Washington perceives, values, and compensates private radiology practices in the U.S. 

“There has never been a better time than now to make sure that our members of Congress understand the impact that certain regulatory and legislative issues can have on both our patients and fellow practitioners in private practice,” said Scott Bundy, MD, FACR, CEO and Chair. “We have begun to educate our representatives about the need for long-term, meaningful reform of physician reimbursement policy.”  

In 2022, coalition members invested in engaging with a lobbying firm that could facilitate access to lawmakers and articulate the needs of private radiology practices and the unique role they play in health care delivery in the U.S.. The relationship with DC lobbying firm Thorn Run Partners is entering its third year, under the guidance of the coalition’s Advocacy Committee, chaired by Linda Wilgus, CPA, MBA, and Executive Director of member group Northwest Radiology Network, Indianapolis, IN.

“ACR and the RBMA do a great job, but there is no one advocating expressly for the independent private practice of radiology,” said Ms. Wilgus. “As an organization, we felt we needed to increase our efforts in the advocacy area and promote the private practice of radiology.” Thorn Run Partners (TRP) is lobbying on behalf of SR, opening doors, connecting the coalition with like-minded organizations and coalitions, and setting up meetings with Congressional representatives, CMS, and other regulatory bodies.

Building Relationships in Washington

In the past several years, TRP has done just that: It has introduced the nation’s leading coalition for independently owned private radiology practices to the legislators in positions to move legislation and helped identify and communicate their legislative needs. The coalition’s 1,700-plus radiologist shareholders have weighed in on issues including the No Surprises Act’s flawed Independent Dispute Resolution process and the need for long-term physician reimbursement reform.

As the only advocacy organization representing the interests of independent, private practice physicians, we are able to bring a unique voice that is respected and valued on Capitol Hill,” noted Shea McCarthy, senior partner, TRP. “Whether we’re talking about improving Medicare reimbursement or addressing the burden of increasing federal regulations, the fact that we are committed to preserving the private practice medicine is a credibility builder — and we are effectively getting the attention of representatives.”

While direct lobbying has been a part of what TRP has provided to Strategic Radiology, equally important has been its provision of substantive policy expertise coupled with an effective grassroots platform and public relations effort. “Each of these pieces are critical to changing the narrative on Capitol Hill,” said Mr. McCarthy.

Behind the Eight Ball

Physician practices began 2024 with a 3.4% Medicare reimbursement cut, as Congress failed to enact a year-end “omnibus” bill that would have likely carried a fix to this shortfall in physician payments. Instead, Congress passed a series of temporary extensions to government spending — the latest extending into early March — complicating the prospects for action on a 2024 MPFS fix.

However, Mr. McCarthy believes that it’s not too late for Congress to take action to avert the 2024 reimbursement cuts, and there will likely be another bite at the apple as Congress appears poised to pass a longer-term funding deal in March.  “Although Congress hasn’t acted yet, there are ongoing discussions about a fix to reduce the cut from 3.4% to 2.15%,” he said. “We’re just waiting for lawmakers to get their act together on a broader government funding deal.”

One emerging development with the potential to impact physician reimbursement in the longer term is the appointment by U.S. Department of Health & Human Services Secretary Xavier Bercerra of Stacy Sanders as Chief Competition Officer, a new role created by the Biden-Harris Administration to help lower health care and prescription drug costs through increased competition.

“We know that increased competition in the marketplace is a good deal for the American people,” Sanders said in a press release. “I look forward to supporting the Biden-Harris Administration’s efforts to increase competition in health care and lower costs, helping build on steps the Administration has already taken as well as identify opportunities to further spur innovation.”

Another positive development is legislation that is rumored to be under development by Ron Wyden (D-Oregon) that would focus on a longer-term physician reimbursement reform. Long-term physician reimbursement reform is a key plank in the Strategic Radiology lobbying platform, and the Advocacy Committee intends to support that in a variety of ways in its 2024 activities.

2024 Agenda

The goals for Strategic Radiology’s 2024 advocacy efforts include:

• Continue efforts to eliminate reductions in Medicare reimbursement;

• Continue efforts to raise the threshold for CMS’ budget neutrality rules and to incorporate an annual inflation factor increase into the Medicare Physician Fee Schedule;

• Continue to monitor and participate in No Surprises Act developments and other legislative developments that impact radiology; and

• Influence/support the Administration’s efforts to investigate mergers and anti-competitive activities.

The fact that the Biden Administration will begin investigating consolidation and private equity in the health care space is particularly encouraging, Ms. Wilgus believes. “We put the patient at the center of everything we do and the fact that this trend is being looked at from the highest level in the federal government is exciting to us,” she said.  “There is a lot going on in government right now, and many distractions. We’re continuing to push for a fix to the MPFS and the continuing resolutions, but as things settle down, we are going to try and figure out how to get Strategic Radiology in front of Ms. Sanders so that we can lean in, influence, and support initiatives to strengthen private practice.”