Sadowsky David, Li Tianyang, Hasan Usama, Harnain Christopher, Gilet Anthony, Gerard Perry
Department of Radiology, Westchester Medical Center, Valhalla, NY.
Department of Radiology, Westchester Medical Center, Valhalla, NY..
Curr Probl Diagn Radiol. 2019 Jan;48(1):1-3. doi: 10.1067/j.cpradiol.2018.05.005. Epub 2018 May 23.
The Medicare Access and CHIP Reauthorization Act of 2015 was signed into law on April 16, 2015, fundamentally altering the way clinicians are reimbursed for the treatment of Medicare patients starting in 2017. Under this new pay-for-performance model, reimbursement will be tied to multiple metrics related to quality and cost of care. A scaled scoring system will require providers to compete for positive reimbursement adjustments, while also penalizing poor performers with negative adjustments. A firm understanding of this new system will be essential for all physicians looking to maximize their reimbursement, particularly diagnostic radiologists and members of other highly focused fields where special considerations lead to alterations in the scoring system.
《2015年医疗保险接入与儿童健康保险计划再授权法案》于2015年4月16日签署成为法律，从根本上改变了自2017年起临床医生治疗医疗保险患者的报销方式。在这种新的按绩效付费模式下，报销将与多个与医疗质量和成本相关的指标挂钩。一个分级评分系统将要求医疗机构为获得正向报销调整而竞争，同时也会对表现不佳者进行负向调整处罚。对于所有希望最大化报销金额的医生来说，深入了解这个新系统至关重要，尤其是诊断放射科医生以及其他高度专注领域的成员，因为特殊考量会导致评分系统有所变化。
