Medicare Access and CHIP Reauthorization Act (MACRA) replaces the current medicare reimbursement schedule with a new pay-for-performance program that's focused on quality, value, and accountability. Merit-based incentive payment systems adjust payment based on performance in four categories such as the quality, cost, promoting interoperability, and improvement activities. A performance measure is a way to calculate whether and how often the healthcare system does what it should. Appropriate-use criteria is defined as a criteria that is evidence-based and assists professionals who order and furnish applicable imaging services to make the most appropriate treatment decisions for a specific clinical condition. Bundled payment for care improvement links payments for multiple services which beneficiaries receive during an episode of care. Comprehensive care for joint replacement is now replaced with MACRA.