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Evaluating the Costs of IR in Health Care Delivery: Proceedings from a Society of Interventional Radiology Research Consensus Panel

2017; Elsevier BV; Volume: 28; Issue: 11 Linguagem: Inglês

10.1016/j.jvir.2017.07.024

1535-7732

Ammar Sarwar, C. Matthew Hawkins, Brian W. Bresnahan, Ruth C. Carlos, Marcelo Guimarães, Katharine L. Krol, Sharon W. Kwan, Walead Latif, Raymond Liu, William D. Marder, Charles E. Ray, Filip Banovac,

Healthcare Policy and Management

Health care reform in the United States has begun to fundamentally change health insurance, reimbursement, quality measurement, and reporting throughout the health care enterprise ( 1 Bohmer R.M.J. The Hard work of health care transformation. N Engl J Med. 2016; 375: 709-711 Crossref PubMed Scopus (58) Google Scholar , 2 Dale C.R. Myint M. Compton-Phillips A.L. Counting better—the limits and future of quality-based compensation. N Engl J Med. 2016; 375: 609-611 Crossref PubMed Scopus (2) Google Scholar ). The final rule defining the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) includes health care costs as a measure of care provided by which physicians will be compared and reimbursement bonuses or penalties subsequently determined ( 3 Federal Register. Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) incentive under the physician fee schedule, and criteria for physician-focused payment models. 2016; (Available at:) (Accessed February 7, 2017)https://www.federalregister.gov/documents/2016/11/04/2016-25240/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment-model-apm Google Scholar ). In addition, alternative payment models (APMs), which account for costs of care, have been implemented for joint replacement, oncology, and end-stage renal disease (ESRD) treatment ( 4 Bishop H. New alternative payment models announced by CMS. http://health.wolterskluwerlb.com/2016/10/new-alternative-payment-models-announced-by-cms/ Google Scholar ). As these APMs determine reimbursements or shared savings for groups of physicians based on cost reductions achieved, costs of care are increasingly influencing physician reimbursement.