Traditional Payment Models in Radiology: Historical Context for Ongoing Reform

Area of Science:

• Health Policy
• Healthcare Economics
• Radiology

Background:

• The Medicare Access and CHIP Reauthorization Act (MACRA) signifies a major shift in healthcare reimbursement.
• It replaces the sustainable growth rate with a system prioritizing quality and alternative payment models.
• The full implementation details of MACRA are still under development.

Purpose of the Study:

• To provide historical context for MACRA's development.
• To highlight key legislative and non-legislative actions influencing MACRA.
• To inform the radiology profession about their role in MACRA-driven payment reform.

Main Methods:

• Historical analysis of healthcare payment reform initiatives.
• Review of legislative and non-legislative actions preceding MACRA.
• Focus on payment quality initiatives and alternative payment model demonstrations.

Main Results:

• MACRA's foundation is built upon prior payment quality and alternative payment model efforts.
• A detailed historical understanding is necessary for effective policy engagement.
• The radiology profession needs to be informed about MACRA's implications.

Conclusions:

• Radiologists must understand MACRA's historical context to engage effectively with policymakers.
• Prior payment reform efforts provide the groundwork for MACRA's implementation.
• Informing policy is essential for defining the radiology profession's future role in value-based care.