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Health Services Research & Policy ■ Clinical Practice Management ■ Training & Education ■ Leadership
Health Services Research & Policy
■ Clinical Practice Management
■ Training & Education ■ Leadership

MACRA Macramé Mashup

  Because nothing says payment models and quality measures like knotted-cord textiles.

 When I first heard the acronym MACRA, I couldn't help but think of macramé, the groovy handcrafted home décor fad of the 1970s. Crafters used yarn, cord, or rope of varying thickness to make everything from hanging plant holders to handbags using a variety of knot patterns. People today are probably most likely to come across macramé in the form of hammocks and, if you have tween girls, friendship bracelets.

If you aren't familiar with MACRA, it stands for Medicare Access and CHIP Reauthorization Act (CHIP is another acronym, specifically the Children's Health Insurance Program). It has to do with delivery-system and payment reform and has two components: MIPs (Merit-Based Incentive Payment System) and APMS (Advanced Alternative Payment Models). MIPs represents PQRS, value-based payment modifier, and EHR combined into a single program. I won't go further down the rabbit hole by spelling out this last batch of abbreviations. Suffice it to say, MACRA can be confusing and complicated but is of critical importance to how radiologists will be paid, so it's something all radiologists should understand.

In a new Radiology Firing Line podcast, host C. Matthew Hawkins, MD, from Emory is joined by Gregory Nicola from Hackensack Radiology Group in New Jersey, an expert on MACRA and its Quality Payment Program. He is an appointee to the Centers for Medicare and Medicaid (CMS) Relative Value Scale Update Committee (RUC) run by the American Medical Association (AMA) and serves on the American College of Radiology (ACR)'s MACRA Committee . Providing additional commentary from are Drs. Harry Jha (Penn) and Richard Gunderman (Indiana).

Without further ado, I invite you to climb into the nearest hammock (or recline on any non-macramé seating) and listen to the newest RFL podcast. You'll learn a thing or two about how MACRA is evolving, like how current quality measures are actually quality surrogates, whereas the future is about outcomes-based measures. And wait until you hear the actual definition of "non-patient-facing physician."



MACRA is like macramé for radiologists. All the acronyms and abbreviations are the knots that join ropes together to form a harmonious whole. But, like the hammock I'm clumsily attempting to climb out of, you need to understand how to handle MACRA so you (and how you get paid as a radiologist) don't end up all tangled.

For more on MACRA, take a look at the ACR MACRA webpage for a well-curated group of resources, including webinars, videos, articles, and tools. These resources include several new items, such as a five-page MIPs improvement activity fact sheet.

Further Reading

Radiology and the New Medicare/MACRA Patient Relationship Codes

Radiologists may now be Accountable for Containing Medicare Costs and Spending under MACRA

Expanding Role of Certified Electronic Health Records Technology in Radiology: The MACRA Mandate

JACR's 10-article MACRA collection

ACR 2018: Your Story Goes Here
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Sunday, 22 October 2017

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