TY - JOUR T1 - Understanding the impact of ‘cost’ under MACRA: a neurointerventional imperative! JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 1005 LP - 1011 DO - 10.1136/neurintsurg-2018-013972 VL - 10 IS - 10 AU - Gabriela Spilberg AU - Gregory N Nicola AU - Andrew B Rosenkrantz AU - Ezequiel Silva III AU - Clemens M Schirmer AU - Brian B Ghoshhajra AU - Nirmal Choradia AU - Rose Do AU - Joshua A Hirsch Y1 - 2018/10/01 UR - http://jnis.bmj.com/content/10/10/1005.abstract N2 - The cost of providing healthcare in the United States continues to rise. The Affordable Care Act created systems to test value-based alternative payments models. Traditionally, procedure-based specialists such as neurointerventionalists have largely functioned in, and are thus familiar with, the traditional Fee for Service system. Administrative charge data would suggest that neurointerventional surgery is an expensive specialty. The Medicare Access and CHIP Reauthorization Act consolidated pre-existing federal performance programs in the Merit-based Incentive Payments System (MIPS), including a performance category called ‘cost’. Understanding cost as a dimension that contributes to the value of care delivered is critical for succeeding in MIPS and offers a meaningful route for favorably bending the cost curve. ER -