Alternative Health Care Models

The Proposed MACRA/MIPS Threshold for Patient-Facing Encounters: What It Means for Radiologists

This report found that CMS’ proposed criteria for special considerations in new payment models would result in many radiologists being evaluated using measures not reflective of their practice. Full Article

Rosenkrantz A.B., Hirsch J.A., Allen B. Jr., Wang W., Hughes D.R., Nicola G. 2017. "The Proposed MACRA/MIPS Threshold for Patient-Facing Encounters: What It Means for Radiologists," Journal of the American College of Radiology, 14(3): 308 - 315.

MACRA, MIPS, and the New Medicare Quality Payment Program: An Update for Radiologists

This report provides an overview of CMS’ proposal for implementing MACRA legislation via the new QPP, paying specific attention to the implications and imperatives for radiologists under MIPS. Full Article

Rosenkrantz, A.B., Nicola G.N., Allen, B., Hughes, D.R., and Hirsch, J.A. 2017. "MACRA, MIPS, and the New Medicare Quality Payment Program: An Update for Radiologists," Journal of the American College of Radiology, 14(3): 316 - 323.

September 19, 2016

Radiology and the Shared Savings ACO

A new Neiman Institute paper, published in collaboration with industrial engineers from Virginia Tech, investigates how the incentives in an alternative payment model, the Accountable Care Organization Share Savings Program, might influence cost, quality, utilization, and technological investment. Read More

Modeling and Designing Health Care Payment Innovations for Medical Imaging

This paper specifically studies the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs) and determines how this incentive program affects computed tomography (CT) use, and how it could be redesigned to minimize unnecessary CT scans. Full Article

Zhang, H., Wernz, C., Hughes, D.R. 2016. "Modeling and Designing Health Care Payment Innovations for Medical Imaging," Health Care Management Science

An Empirical Framework for Breast Screening Bundled Payments

This study reports that breast cancer screening provides a framework for radiologist-led bundled payment models. Full Article

Hughes, D.R., Jiang, M., McGinty, G.B., Shetty, S., Duszak Jr, R. 2017. "An Empirical Framework for Breast Screening Bundled Payments," Journal of the American College of Radiology, 14(1): 17 - 23.

July 19, 2016

Data and Analytics: Leveling the New Payment World Playing Field

“Savvy radiologists who avail themselves of [ICE-T] will be prepared to play strong offense not just with joint replacement bundles, but with any inpatient bundled payment initiative CMS throws at them,” says Neiman Institute Affiliate Senior Research Fellow Richard Duszak, MD, FACR. Read More

Alternative Payment Models in Radiology: The Legislative and Regulatory Roadmap for Reform

This paper describes 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. Full Article

Silva, E., McGinty, G.B., Hughes, D.R., and Duszak Jr, R. 2016. "Alternative Payment Models in Radiology: The Legislative and Regulatory Roadmap for Reform," Journal of the American College of Radiology, 13(10): 1176 - 1181.

Traditional Payment Models in Radiology: Historical Context for Ongoing Reform

This paper provides a detailed historical context for payment reform, focusing on the payment quality initiatives and alternative payment model demonstrations that helped provide the foundation of future MACRA-driven payment reform. Full Article

Silva, E., McGinty, G.B., Hughes, D.R., and Duszak Jr, R. 2016. "Traditional Payment Models in Radiology: Historical Context for Ongoing Reform," Journal of the American College of Radiology, 13(10): 1171 - 1175.

March 12, 2015

What’s the Value of Value-Based Payments if We Can’t Measure Value?

Aligning with calls by many to abolish fee-for-service as we know it, the Centers for Medicare and Medicaid Services recently announced its target that half of all payments will be quality- or value-based by the end of 2018. It’s a laudable goal, but is it achievable in a world in which no one can agree on how to measure quality and value? Read More

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November 7, 2014

Beyond Fee-For-Service: Emerging Payment Models in Radiology

This report highlights two emerging models being developed by the Neiman Institute designed to align provision and payment of specialty care with efforts to ensure a sustainable, high quality health care system. Read More