July 12, 2021

MACRA - What Radiology Medical Imaging Department need to know

Kovey Kovalan

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 was one of the most prominent pieces of legislation regarding health to be passed in the US Congress. The legislation includes significant takeaways for radiology service providers. MACRA shifts the system of Medicare reimbursements to a Merit-Based Incentive Payments System (MIPS). The degree to which medical imaging service providers comply with its guidelines would determine whether they would gain additional monetary benefits or end up paying penalties. As such a greater discussion is required on these guidelines so that service providers can optimize their operations in compliance with them.

What are the indicators?

The MIPS is based on four factors with different weightage:

Quality (PQRS/VBM) – 50%

Advancing Care Information – 25%

Clinical Practice Improvement – 15%

Resource Use – 10%

The Main Takeaways for Radiology

MACRA regulations specify more than twenty criteria that radiology service providers should be aware of. Most of these radiology related metrics fall in the field of quality (of the four main factors).

The issue of medical image sharing has figured prominently in the regulations. There is an active push to provide for the sharing of images between healthcare institutions and preventing patients from being unnecessarily subjected to repeated radiation. Thus, robust technology which provides for easy and efficient sharing of medical images (DICOM) would be incentivized and the use of outdated technology which is not capable of hassle-free sharing of medical images would result in penalties.

To further enhance the efforts to minimize the instances of patients being subjected to unwanted radiation, the regulations also lay emphasis on proper documentation of radiology reports, maintenance of radiation dose index registry, etc. Again, the requirement for medical imaging centers here is efficient technology that can cater to these needs of efficient documentation.

The third important aspect that MACRA regulations specify for radiology is related to follow-up on the recommendation of radiologists. This would also be considered while reimbursement of Medicare is under process. The low performance in the aspect of following up on recommendations was the main reason for this aspect to find specific mention in the regulations.

LifeVoxel solutions that help you stay MACRA complied

LifeVoxel provides high-end medical imaging solutions that are powered by Graphical Processing Units (GPUs) and Artificial Intelligence (AI). Underlying the operations is a powerful cloud computing mechanism. The company invests a great deal in research and development, striving to bring the best to the field of medical imaging.

An examination of LifeVoxel’s solutions would make it clear why it is the best choice available in the market to ensure compliance with MACRA regulations. The powerful cloud computing mechanism that the company uses is tailor-made for handling medical imaging data, catering to the latter’s specific requirements. As such it helps providers to easily share medical images across platforms and locations. The cloud computing solution also allows for easy indexing and organizing the data. This, in turn, makes it easy to pull up scan images that patients have previous taken. The AI-powered mechanisms help to decrease the potential for human errors while reading the images. This would lead to better performance in follow-up activities. Providers would be able to significantly benefit from this as all this is exactly what is incentivized by the MACRA regulations with respect to radiology.

Significant gains can be made by medical imaging providers while complying with the MACRA regulations. As such providers should opt for solutions that make use of efficient technology that can comply with the requirements.

Congress passed the landmark bipartisan legislation MACRA (Medicare Access and CHIP Reauthorization Act) in April 2015, which permanently replaced the Sustainable Growth Rate formula and established two new tracks for physician payment.[1]


[1] 5 MACRA takeaways for radiologists by Solomon Banjo and Erin Lane URL https://www.advisory.com/research/imaging-performance-partnership/the-reading-room/2016/05/macra-proposed-rule

Where to now?

For more information on this article or to view our software in action, please don't hesitate to schedule a virtual tour.

Recent articles