SCAI fighting for interventional cardiologists amid challenging payment policies

“People may think about that as something that is harmful, because that's how we've been basing our RVUs and how we get paid for our procedures. But on the flip side, this could be the opportunity for us to look at everything and say, 'Look, we need to be at the table just like everybody else.' In fact, we're the ones doing the actual physical work of taking care of patients and we need to be valued by society,” Naidu explained.

He added that SCAI is now “big enough to have a seat at that table” as it works to secure fair valuation for procedures and advocate for physicians’ role in patient care.

Naidu expressed frustration with the current RUC system, which he said effectively pits specialties against one another.

“It takes a certain amount of money and tells the physicians to fight among themselves because if somebody gets a little bit more money, money has to go down somewhere else,” he said. “Fundamentally it doesn’t make a lot of sense and it’s great for Medicare because it forces all the payments to go down over time.”

This year, Naidu noted, CMS has sometimes ignored RUC recommendations. “They have actually have not taken the RUC’s opinion on RVUs and have been able to try to decrease that,” he said, calling it a breach of trust that cheats in the rules.

He also took issue with Medicare’s new “efficiency adjustment,” which calls for cuts to pohyaiocian pay because as they perform procedures over time they become more efficient at it. But Naidu said the policy arbitrarily assumes procedures should become cheaper over time.

“If things are more efficient, take less time, but you have to get the same quality of work, maybe that’s a higher value, not a lesser value,” Naidu argued.

Naidu said SCAI plans to advocate for a system that measures true value to patients and society, not just cost savings. “The value shouldn’t be for the people paying. It really is going to have to be for the society in general,” he said. “The value is not how it saves money for the system. And that’s the fundamental change that we have to do.”

While CMS has announced a transition toward a value-based model by 2030, Naidu cautioned that such systems often underestimate costs.

“The lump sum always underestimates, and then over time that lump sum gets less and less,” he said. To counterbalance this, he said, “we need to form better coalitions that can fully lobby in a way that balance out the lobbies from the other constituents.”

Naidu said SCAI has been quietly building new partnerships with other medical groups to strengthen its influence in Washington. 

“A lot is going to be coming out in the next few months showing where we’re building alliances, how we’re making an impact, how we’re putting things in place so that we will have more touch points and more face time with Congress,” he said.

He also underscored the importance of membership growth, which increases representation within the AMA and influence on payment policy.

“The more members we have, the more that we can have more representation on the RUC. So I do encourage people to join SCAI because as the numbers go up, we may have a second representative … and so this is where we have more power within the AMA and the RUC to position for cardiovascular care in particular,” Naidu said.

Ultimately, Naidu said SCAI’s goal is not only to protect interventional cardiologists’ payments, but to reshape how the system values medical innovation and patient care. 

“It would be far better if we changed the system so that everybody who’s growing and contributing to society can have that valued in a way that the average person on the street would say, well, that makes sense for that to be valued,” he said.