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The Burwell roadmap
  1. Joshua A Hirsch1,
  2. Thabele M Leslie-Mazwi1,
  3. Robert M Barr2,
  4. Geraldine McGinty3,
  5. Gregory N Nicola4,
  6. Aman B Patel1,5,
  7. Laxmaiah Manchikanti5,6
  1. 1NeuroEndovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Mecklenburg Radiology Associates PA, Charlotte, North Carolina, USA
  3. 3Department of Radiology, Weill Cornell Medical College, New York, New York, USA
  4. 4Hackensack University Medical Center, Hackensack, New Jersey, USA
  5. 5Pain Management Center of Paducah, Paducah, Kentucky, USA
  6. 6Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, Kentucky, USA
  1. Correspondence to Dr Joshua A Hirsch, NeuroEndovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; Hirsch{at}


In January 2015 the current Secretary of the Department of Health and Human Services (HHS) outlined a bold initiative to shape the delivery of healthcare through a set of strategies aimed at improving the quality of care and reducing the growth of healthcare costs. The strategies include increasing payment incentives tied to higher value care, increasing care coordination and integration, and increasing access to information to guide patients and clinicians. Significantly, the proposal includes specific goals for alternative payment models and value-based payments for the first time in the history of the Medicare program.

  • Economics

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