title: Traditional Payment Models in Radiology: Historical Context for Ongoing Reform.
abstract: The passage of the Medicare Access and CHIP Reauthorization Act (MACRA) replaces the sustainable growth rate with a payment system based on quality and alternative payment model participation. The general structure of payment under MACRA is included in the statute, but the rules and regulations defining its implementation are yet to be formalized. It is imperative that the radiology profession inform policymakers on their role in health care under MACRA. This will require a detailed understanding of prior legislative and nonlegislative actions that helped shape MACRA. To that end, the authors provide a detailed historical context for payment reform, focusing on the payment quality initiatives and alternative payment model demonstrations that helped provide the foundation of future MACRA-driven payment reform.
authors.affiliation: South Texas Radiology Group, San Antonio, Texas; University of Texas Health Science Center at San Antonio, San Antonio, Texas. Electronic address: zekesilva3@gmail.com.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Silva
authors.affiliation: Weill Cornell Medicine, New York, New York.
authors.forename: Geraldine B
authors.initials: GB
authors.lastname: McGinty
authors.affiliation: Harvey L. Neiman Health Policy Institute, Reston, Virginia; George Mason University, Fairfax, Virginia.
authors.forename: Danny R
authors.initials: DR
authors.lastname: Hughes
authors.affiliation: Harvey L. Neiman Health Policy Institute, Reston, Virginia; Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Richard
authors.initials: R
authors.lastname: Duszak
mesh_terms: D005102:Health Expenditures; D006291:Health Policy; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000191:economics* / Q000331:legislation & jurisprudence*; D011787:Quality of Health Care; D011871:Radiology / Q000191:economics*; D012052:Reimbursement, Incentive / Q000191:economics* / Q000331:legislation & jurisprudence*; D014481:United States
keywords: Affordable Care Act (ACA); Medicare Access and CHIP Reauthorization Act (MACRA); Merit-Based Incentive Payment System (MIPS); Physician Quality Reporting System (PQRS); alternative payment models