New Neiman Health Policy Institute report examines radiology payment models
A new Harvey L. Neiman Health Policy Institute report discusses the Medicare Access and CHIP Reauthorization Act (MACRA) and its implications for radiology. The two-part series, supported by the Neiman Institute through American College of Radiology Foundation funding raised through a private practice donation, explores how radiologists may succeed in the new payment landscape. The report is published online in the Journal of the American College of Radiology (JACR).
"The recent passage of MACRA has accelerated the evolution of provider payment from fee-for-service to payment models intended to support quality, coordinated care and lower costs," said Ezequiel "Zeke" Silva III, MD, FACR, a member of the Neiman Institute's advisory board and chair of the ACR Commission on Economics. "To understand this new payment landscape, radiologists must understand the legislative and regulatory changes which set the stage for MACRA. They must also understand how the new payment system is structured, which policymakers are influencing its evolution and the ways in which radiologists may benefit from it."
To satisfy those needs, Silva and his colleagues published the comprehensive report. The first part of the series provides the historical context for payment reform through detail on a number of relevant legislative and non-legislative actions. In the second part of the series, the authors describe the recent MACRA legislation, including its impacts on payment, the timeline involved and how organizations, including the ACR, are helping to share its rules and regulations.
MACRA replaces the Sustainable Growth Rate with a payment system based on the Merit-Based Incentive Payment System (MIPS) and incentives for alternative payment model participation. MIPS assigns physicians a composite performance score between 0 and 100, based on four performance categories: quality, resource use (also referred to as Cost), meaningful use (also referred to as Advancing Care Information) and clinical practice quality improvement activities. MACRA requires the establishment of the specific criteria for physician-focused alternative payment models.
"This changing landscape creates challenges but also creates opportunities to ensure radiology's relevancy and success as delivery systems change," said Geraldine McGinty, MD, MBA, FACR, vice chair of the ACR Board of Chancellors and a member of the Neiman Institute's advisory board. "This will require a high level of proactive engagement by radiologists, their practices and their specialty societies."
Silva, McGinty and their co-authors hope the series will prompt the creation of a research agenda and also practical strategic guidance to inform new payment model discussions.
"It is imperative that radiologists understand the structure of MACRA, its impacts on payment, the timeline for its implementation and the organizations impacting its specifics," added Silva.