PQRS and the MACRA: Value-Based Payments Have Moved from Concept to Reality

References

1. 1.↵
   The Medicare Access and CHIP Reauthorization Act of 2015. https://www.congress.gov/bill/114th-congress/house-bill/2. Accessed June 2, 2015.
2. 2.↵
   2. Manchikanti L,
   3. Singh V,
   4. Caraway DL, et al

   . Medicare physician payment systems: impact of 2011 schedule on interventional pain management. Pain Physician 2011;14:E5–33 pmid:21267048

   PubMed
3. 3.↵
   2. Hsiao WC,
   3. Braun P,
   4. Kelly NL, et al

   . Results, potential effects, and implementation issues of the Resource-Based Relative Value Scale. JAMA 1988;260:2429–38 doi:10.1001/jama.260.16.2429 pmid:3050171

   CrossRefPubMedWeb of Science
4. 4.↵
   2. Hirsch JA,
   3. Silva E 3rd.,
   4. Nicola GN, et al

   . The RUC: a primer for neurointerventionalists. J Neurointerv Surg 2014;6:61–64 doi:10.1136/neurintsurg-2012-010636 pmid:23335447

   Abstract/FREE Full Text
5. 5.↵
   2. Seidenwurm DJ,
   3. Burleson JH

   . The Medicare conversion factor. AJNR Am J Neuroradiol 2014;35:242–43 doi:10.3174/ajnr.A3674 pmid:23868163

   FREE Full Text
6. 6.↵
   Balanced Budget Act of 1997. https://www.gpo.gov/fdsys/pkg/PLAW-105publ33/content-detail.html. Accessed July 1, 2015.
7. 7.↵
   2. Baumol WJ

   . The Cost Disease: Why Computers Get Cheaper and Health Care Doesn't. New Haven: Yale University Press; 2012:16–32
8. 8.↵
   2. Hirsch JA,
   3. Rosman DA,
   4. Liu RW, et al

   . Sustainable growth rate 2013: time for definitive intervention. J Neurointerv Surg 2013;5:382–86 doi:10.1136/neurintsurg-2013-010776 pmid:23645571

   Abstract/FREE Full Text
9. 9.↵
   2. Hirsch JA,
   3. Manchikanti L

   . The sustainable growth rate: a 2014 update. J Neurointerv Surg 2014;6:411–12 doi:10.1136/neurintsurg-2014-011170 pmid:24569574

   FREE Full Text
10. 10.↵
    Committee on Quality of Health Care in America, Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington DC: National Academies Press; 2001
11. 11.↵
    Committee on Redesigning Health Insurance Performance Measures, Payment, and Performance Improvement Programs and Board on Health Care Services. Rewarding Provider Performance: Aligning Incentives in Medicare (Pathways to Quality Health Care Series). Washington DC: National Academies Press; 2007
12. 12.↵
    2. Tompkins CP,
    3. Higgins AR,
    4. Ritter GA

    . Measuring outcomes and efficiency in Medicare value-based purchasing. Health Aff (Millwood) 2009;28:w251–61 doi:10.1377/hlthaff.28.2.w251 pmid:19174387

    Abstract/FREE Full Text
13. 13.↵
    Tax Relief and Health Care Act of 2006. https://www.gpo.gov/fdsys/pkg/PLAW-109publ432/html/PLAW-109publ432.htm. Accessed April 15, 2016.
14. 14.↵
    Centers for Medicare & Medicaid Services, Department of Health and Human Services. Physician Quality Reporting Initiative: 2007 Reporting Experience. December 3, 2008; https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/downloads/PQRI2007ReportFinal12032008CSG.pdf. Accessed April 14, 2016.
15. 15.↵
    Patient Protection and Affordable Care Act. 2010. https://www.hhs.gov/healthcare/about-the-law/read-the-law/index.html. Accessed April 14, 2016.
16. 16.↵
    2. Manchikanti L,
    3. Hirsch JA

    . Patient Protection and Affordable Care Act of 2010: a primer for neurointerventionalists. J Neurointerv Surg 2012;4:141–46 doi:10.1136/neurintsurg-2011-010036 pmid:21990501

    CrossRefPubMed
17. 17.↵
    2. Burwell SM

    . Setting value-based payment goals: HHS efforts to improve U.S. health care. N Engl J Med 2015;372:897–99 doi:10.1056/NEJMp1500445 pmid:25622024

    CrossRefPubMedWeb of Science
18. 18.↵
    2. Hirsch JA,
    3. Leslie-Mazwi TM,
    4. Barr RM, et al

    . The Burwell roadmap. J Neurointerv Surg 2016;8:544–46 doi:10.1136/neurintsurg-2015-011706 pmid:25744382

    Abstract/FREE Full Text
19. 19.↵
    2. Hirsch JA,
    3. Leslie-Mazwi TM,
    4. Barr RM, et al

    . The Bundled Payments for Care Improvement Initiative. J Neurointerv 2016;8:547–48 doi:10.1136/neurintsurg-2015-011746 pmid:25829366

    CrossRefPubMed
20. 20.↵
    2. Hirsch JA,
    3. Leslie-Mazwi TM,
    4. Meyers PM, et al

    . Accountable care. J Neurointerv 2015 Jun 17. [Epub ahead of print] pmid:26085569
21. 21.↵
    2. Meehan TM,
    3. Harvey HB,
    4. Duszak R Jr., et al

    . Accountable Care Organizations: what they mean for the country and for neurointerventionalists. J Neurointerv Surg 2016;8:654–57 doi:10.1136/neurintsurg-2015-011809 pmid:25987588

    Abstract/FREE Full Text
22. 22.↵
    2. Hirsch JA,
    3. Leslie-Mazwi TM,
    4. Patel AB, et al

    . MACRA: background, opportunities and challenges for the neurointerventional specialist. J Neurointerv Surg 2016;8:868–74 doi:10.1136/neurintsurg-2015-011952 pmid:26220409

    Abstract/FREE Full Text
23. 23.↵
    2. Hirsch JA,
    3. Harvey HB,
    4. Barr RM, et al

    . Sustainable growth rate repealed, MACRA revealed: historical context and analysis of recent changes in Medicare physician payment methodologies. AJNR Am J Neuroradiol 2016;37:210–14 doi:10.3174/ajnr.A4522 pmid:26585253

    FREE Full Text
24. 24.↵
    Department of Health and Human Services, Centers for Medicare & Medicaid Services. 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; https://s3.amazonaws.com/public-inspection.federalregister.gov/2016–10032.pdf. Accessed May 17, 2016.
25. 25.↵
    Centers for Medicare & Medicaid Services. Health Care Payment Learning and Action Network. https://innovation.cms.gov/initiatives/Health-Care-Payment-Learning-and-Action-Network/. Accessed April 14, 2016.
26. 26.↵
    Alternative Payment Model Framework and Progress Tracking (APM FPT) Work Group. Alternative Payment Model (APM) Framework: Final White Paper. https://hcp-lan.org/workproducts/apm-whitepaper.pdf. Accessed April 14, 2016.
27. 27.↵
    2. Anumula N,
    3. Sanelli PC

    . Physician Quality Reporting System. AJNR Am J Neuroradiol 2011;32:2000–01 doi:10.3174/ajnr.A2912 pmid:22095966

    Abstract/FREE Full Text
28. 28.↵
    2. Manchikanti L,
    3. Hirsch JA

    . Obama health care for all Americans: practical implications. Pain Physician 2009;12:289–304 pmid:19305481

    PubMedWeb of Science
29. 29.↵
    United States Government. Federal Register. https://www.gpo.gov/fdsys/pkg/FR-2015-11-16/pdf/2015-28005.pdf. Accessed April 12, 2016.
30. 30.↵
    2. Manchikanti L,
    3. Hammer M,
    4. Benyamin RM, et al

    . Physician Quality Reporting System (PQRS) for interventional pain management practices: challenges and opportunities. Pain Physician 2016;19:E15–32 pmid:26752483

    PubMed
31. 31.↵
    National Radiology Data Registry. http://www.acr.org/∼/media/ACR/Documents/PDF/QualitySafety/NRDR/2014%20NonPQRS%20QCDR%20Measures.pdf. Accessed April 9, 2016.
32. 32.↵
    Centers for Medicare & Medicaid Services. The Merit-Based Incentive Payment System (MIPS) & Alternative Payment Models (APMs): Delivery System Reform, Medicare Payment Reform, & the MACRA. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html. Accessed April 10, 2016.
33. 33.↵
    Centers for Medicare & Medicaid Services. Physician Compare Initiative. https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/physician-compare-initiative/. Accessed April 10, 2016.
34. 34.
    Centers for Medicare & Medicaid Services, Physician Quality Reporting System. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/MeasuresCodes.html. Accessed April 10, 2016.