Over the past few years, the SR Advocacy Committee has steadily elevated its presence in Washington, DC, working to provide a voice for independent, private practices and prevent harmful reimbursement cuts from being implemented.

With the strategic counsel of its advocacy partner Thorn Run Partners (TRP)— and the leadership of longtime health policy advisor Shea McCarthy — SR has positioned itself as an increasingly influential player in national reimbursement policy debates. While the path to comprehensive Medicare payment reform remains challenging, the Committee remains optimistic that additional relief on Medicare payment cuts for 2025 could arrive this summer.

"We were disappointed, but we are not alone," notes Christopher Day, MD, MBA, chair of the SR Advocacy Committee, in response to Congress passing an appropriations bill for fiscal year (FY) 2025 without addressing the ongoing lapse in Medicare reimbursement.  More than 100 physician organizations, including the AMA and the ACR, shared in the disappointment when the 'doc fix' did not make it into the continuing resolution (CR) to fund the government in mid-March.

The hope was that the Medicare Patient Access and Stabilization Act (H.R. 879) — introduced by Rep. Greg Murphy (R-NC), physician and member of the so-called GOP Doctors Caucus — would be attached to the CR before it passed in March.  As written, H.R. 879 would reverse the 2025 cut and add an inflation factor retroactive to Jan. 1, 2025. Unfortunately, extreme fiscal austerity in Washington, DC carried the day, and the 'doc fix' was not attached to the CR.

"We have to pivot as a Committee now," Dr. Day says, explaining that the budget reconciliation process offers the next opening for the doc-pay fix. "Conversations are taking place in Washington and will extend into late Spring and Summer. Right now, Republicans are more fixated on higher cost items and achieving budgetary savings, and with a $2 billion cost [the estimated budgetary impact of rolling back the 2.8% physician pay cut], we are fighting to be a priority.  But Rep. Murphy has been assured that physician pay cuts will be fixed in the budget reconciliation process this summer. I haven't given up hope because this is our next best opportunity now to fight for our case."

Laying the Foundation for Meaningful Change 

A team from SR led by Shea McCarthy of TRP began to lay the groundwork for rolling back the cuts last summer after the 2025 MPFS Proposed Rule was issued. In addition to Dr. Day and Mr. McCarthy, the team included SR CEO Scott Bundy, MD, FACR, and several members of the SR Advocacy Committee. They were encouraged after reading the White Paper issued by the Senate Committee on Finance on May 7, 2024, that outlined the consequences of year-after-year physician pay cuts.

"We had a group that went to Washington DC and met with six of the key legislators on the Senate Committee on Finance, and we applauded their work," Dr. Bundy shares. "Although the immediate goal was to turn back the latest round of cuts, SR's longer range, more important goal is to accomplish long-term, sustainable physician reimbursement reform."

Over decades, year-after-year cuts have resulted in a huge pressure on private practitioners, not just radiology but all independent practices.  "With these cuts, we are finding it more and more difficult to sustain our businesses," Dr. Day emphasizes. "I am concerned that elected officials fail to realize that we are not only subject to intense regulation and high compliance costs, but also serve as major employers.

"The feedback we got last summer was, 'Hey, we get it, we want to stop these cuts also, but here's our problem: we've got to find a way to pay for it because you're asking for something that's going to cost about $2 billion. If we stop the cut for you and give you an inflation factor, that price tag would balloon up to over a hundred billion dollars over a 10-year period.' We recognize that is a big challenge that must be overcome," ," Dr. Day observes.

The Short-Term Objective

For now, the Advocacy Committee is focused on the short-term objective to roll back the 2.8% physician pay cut in 2025, hopefully this summer. "This is about keeping our independent practices open," Dr. Day observes. "We're trying to impress upon our legislators that because of the current economic pressures, we have no other options aside from asking for better reimbursement rates from private insurance and/or requesting revenue support from our hospitals, or we will have no choice but to limit access to Medicare and Medicaid beneficiaries. 

A key factor complicating the situation in radiology is the workforce crisis: Radiology practices and hospitals are struggling to meet escalating volumes. "Our main crisis right now is that we don't have enough radiologists to read the number of studies that are being produced," Dr. Day explains. "If you keep cutting reimbursement, and we don't have enough salary to recruit radiologists, then we're in a very bad cycle. If practices can't hire enough radiologists to manage the volume, we have an access problem."

Dr. Day is a passionate advocate for independent private radiology practices, which provide not just critically important radiological services for many of the 5,000+ community hospitals throughout the nation but also participate in radiological safety oversight and quality improvement initiatives. Some private practice radiology groups operate independent outpatient imaging centers, providing a lower cost option for many imaging procedures.

However, given the current economic trends of year-after-year cuts, the future of the private practice model of care delivery is far from assured. "Private equity and academia are both engaged in acquiring private radiology practices, thereby removing an efficient, patient-centered option for the delivery of care from our health care system," Dr. Day impresses.

Strategic Representation in Washington

SR made the decision to hire an advocacy firm in 2021, with all groups contributing equally to the cost that was subsequently rolled into membership dues. Dr. Day believes that hiring TRP to lead advocacy in Washington, DC, was an important milestone in SR's history.

"It was a very tactical move by Strategic Radiology, because it helped us to have an inside understanding of how things work in Washington, DC, and made us more effective in getting our message across about the consequences of these year-after-year cuts," he observes. "Shea has been phenomenal in helping to educate us on how the government works and the people we need to talk to. I can't stress how important relationship-building is in Washington."

Mr. McCarthy is a seasoned lobbyist with TRP, a top 10 lobbying firm in Washington D.C., who also has experience supporting advocacy work for the Radiology Business Management Association. His bipartisan approach and deep familiarity with health policy make him a powerful voice on behalf of physician-owned practices. "Strategic Radiology represents a unique voice in Washington, DC," Mr. McCarthy explains. "That voice advocates for 100% physician-owned businesses that deliver high quality care. Lawmakers need to understand the costs, the responsibilities, and the role that private practices play in care delivery in America. We don't have to worry about creating financial turns to investors — this is about supporting an environment where physicians can focus on caring for their patients."

Since the relationship began, Mr. McCarthy has arranged several trips to Capitol Hill for SR members, dozens of virtual visits with elected representatives, and multiple site visits at SR member practices across the country. "Hosting your local representatives at your practice is one of the most valuable advocacy activities a private practice radiologist can perform," Mr. McCarthy says. 

"Our goal isn't just to push back on annual cuts — it's to reshape the payment conversation around long-term sustainability, especially for physician-led, patient-centered care models," McCarthy adds. "That's the message we're driving home with lawmakers."

For the moment, the long-range goal to provide physicians with an annual inflation adjustment is on the back burner. "Our legislators keep countering and saying, 'That's a lot of money'," Dr. Day reports. "And they're also asking us, 'What can you do to help cut costs?'"

Dr. Day and Mr. McCarthy continue to harbor hope that relief from the 2025 cuts will be forthcoming in 2025. "We have had some small wins with some short-term rollbacks to the cuts — what we call patches," Dr. Day says. "Until Congress is ready to answer the hundred-billion-dollar question of how to fix this issue long-term, we may be stuck in this cycle of fighting to avoid year-over-year cuts."