title: Alternative Payment Models in Radiology: The Legislative and Regulatory Roadmap for Reform.
abstract: The Medicare Access and CHIP Reauthorization Act (MACRA) replaces the sustainable growth rate with a payment system based on the Merit-Based Incentive Payment System and incentives for alternative payment model participation. It is important that radiologists understand the statutory requirements of MACRA. This includes the nature of the Merit-Based Incentive Payment System composite performance score and its impact on payments. The timeline for MACRA implementation is fairly aggressive and includes a robust effort to define episode groups, which include radiologic services. A number of organizations, including the ACR, are commenting on the structure of MACRA-directed initiatives.
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; D006801:Humans; D006278:Medicare / Q000191:economics* / Q000331:legislation & jurisprudence*; D011445:Prospective Payment System / Q000191:economics* / Q000331:legislation & jurisprudence*; D011871:Radiology / Q000191:economics*; D012051:Reimbursement Mechanisms / Q000191:economics / Q000331:legislation & jurisprudence; D012052:Reimbursement, Incentive / Q000191:economics* / Q000331:legislation & jurisprudence*; D014481:United States
keywords: Center for Medicare and Medicaid Innovation (CMMI); Health Care Payment and Action Network (HCPLAN); Medicare Access and CHIP Reauthorization Act (MACRA); Merit-Based Incentive Payment System (MIPS); Physician Quality Reporting System (PQRS); alternative payment models (APMs); clinical practice quality improvement activities; episode groups; resource use