title: Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and Alternative Payment Models in dermatology.
abstract: With the introduction of the Medicare Access and Children's Health Insurance Program Reauthorization Act, clinicians who are not eligible for an exemption must choose to participate in 1 of 2 new reimbursement models: the Merit-based Incentive Payment System or Alternative Payment Models (APMs). Although most dermatologists are expected to default into the Merit-based Incentive Payment System, some may have an interest in exploring APMs, which have associated financial incentives. However, for dermatologists interested in the APM pathway, there are currently no options other than joining a qualifying Accountable Care Organization, which make up only a small subset of Accountable Care Organizations overall. As a result, additional APMs relevant to dermatologists are needed to allow those interested in the APMs to explore this pathway. Fortunately, the Medicare Access and Children's Health Insurance Program Reauthorization Act establishes a process for new APMs to be approved and the creation of bundled payments for skin diseases may represent an opportunity to increase the number of APMs available to dermatologists. In this article, we will provide a detailed review of APMs under the Medicare Access and Children's Health Insurance Program Reauthorization Act and discuss the development and introduction of APMs as they pertain to dermatology.
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: john.barbieri@uphs.upenn.edu.
authors.forename: John S
authors.initials: JS
authors.lastname: Barbieri
authors.affiliation: Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Miller
authors.affiliation: Yale University, New Haven, Connecticut; Department of Dermatology, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Harrison P
authors.initials: HP
authors.lastname: Nguyen
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Howard P
authors.initials: HP
authors.lastname: Forman
authors.affiliation: Yale University, New Haven, Connecticut; Department of Public Health (Health Policy), Economics, and Management, Yale University, New Haven, Connecticut.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Bolognia
authors.affiliation: Department of Dermatology, University of Iowa (Carver) College of Medicine, Iowa City, Iowa.
authors.forename: Marta J
authors.initials: MJ
authors.lastname: VanBeek
mesh_terms: D002648:Child; D003880:Dermatology / Q000639:trends*; D005544:Forecasting; D006801:Humans; D000072641:Medicare Access and CHIP Reauthorization Act of 2015; D008962:Models, Theoretical; D012051:Reimbursement Mechanisms; D014481:United States
keywords: Alternative Payment Models; Medicare Access and Children's Health Insurance Program Reauthorization Act; Merit-based Incentive Payment System; bundled payment; dermatology; health care reform; payment reform