This summer, the SIR and SIR Foundation Board of Directors met to discuss the main challenges and opportunities facing IR right now. This conversation yielded strong consensus on the need to quantify and communicate the value of IR services and physicians within healthcare delivery. These are two separate, yet crucially intwined challenges.
We know that IR therapies offer cost-saving opportunities that can extend the quality of care, and that IR physicians are well situated to be longitudinal providers, serving as an access point for underserved patients. But how do we make everyone else understand this?
The first step is quantifying value by gathering data. In his leadership column, Dr. Lookstein speaks to the importance of efforts like VIRTEX in sourcing this data. Data strategy is as critical as message strategy. Influence will depend on credible, targeted evidence.
The second step is to communicate what that data tells us about IR therapies and value.
Communicating IR value can take many forms, but one of the most impactful ways is through advocacy. The Centers for Medicare & Medicaid Services (CMS) and policymakers are high leverage stakeholders and should be prioritized for strategic engagement.
IR has traditionally maintained strong engagement with CMS, but that influence appears to be waning. In the proposed Medicare Physician Fee Schedule (MPFS) rule for calendar year (CY) 2026, CMS is introducing an "efficiency adjustment" that would reduce work RVUs and intra-service physician time for non-time-based services. This reduction is tied to the Medicare Economic Index (MEI) productivity adjustment, using a five-year lookback period. If implemented, it would lead to a 2.5% across-the-board cut to baseline physician work RVUs and intra-service time in 2026. Despite SIR’s respected role in the AMA’s CPT and RUC processes, structural payment reductions persist. There is an increasing need for stronger advocacy at the carrier level to protect IR reimbursement.
IR’s mission and values already align with CMS’s strategic goals, such as reducing inpatient utilization, enhancing ambulatory care and addressing health equity. However, we can recommit ourselves better showcasing these values, along with continuing to advance clinical guidelines and MIPS-relevant measures. And we must provide data, especially data focused on the cost comparisons of IR therapies versus surgery, the impact of reduced hospital stays, robust peer-reviewed Level 1 evidence, and the growing shift of site-of-service to ASCs/OBLs.
To advocate effectively, SIR must help policy makers understand the relevance of IR therapies to their constituents. This means quantifying the percentage of constituents impacted by IR and identifying access-to-care and workforce gaps. It also means streamlining our advocacy asks around key topics like increasing IR residency slots, preventing reimbursement cuts and supporting state-level procedure approvals. When IR’s impact is framed through the lens of constituent impact and budget implications, policymakers are better able to become IR advocates themselves.
We have the roadmap in place, and are working on putting each piece in position, but the Board of Directors is only the first stop. Data collection and advocacy cannot happen without the insight, energy and dedication of SIR members.
