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The episode, the PTAC, cost, and the neurointerventionalist
  1. Joshua A Hirsch1,
  2. Andrew B Rosenkrantz2,
  3. Raymond W Liu3,
  4. Laxmaiah Manchikanti4,5,
  5. Gregory N Nicola6
  1. 1NeuroEndovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Department of Radiology, NYU Langone Medical Center, New York, New York, USA
  3. 3Department of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  4. 4Pain Management Center of Paducah, Paducah, Kentucky, USA
  5. 5Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, Kentucky, USA
  6. 6Hackensack Radiology Group, Hackensack, New Jersey, USA
  1. Correspondence to Dr Joshua A Hirsch, NeuroEndovascular Program, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Gray 241B, Boston, MA 02114, USA; Hirsch{at}


Episodic care forms a payment methodology of increasing relevance to neurointerventional specialists and other providers. Episodic care payment models are currently recognized in both payment paths described by the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act (MACRA): the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. Understanding the cost of care, as well as how such costs are shaped in the context of episodic care, will be critical to success in both of these paths.

  • Economics

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  • Contributors JAH drafted the original manuscript. All authors reviewed the draft, provided meaningful edits, and contributed to the final version.

  • Competing interests JAH consults for Medtronic. ABR is supported by a Research Grant from the Harvey L Neiman Health Policy Institute.

  • Provenance and peer review Not commissioned; internally peer reviewed.