Abstract

As Medicare costs continue to rise fueled in large part by new devices and pricey drugs, the federal government now spends 50% more on health care than it does to fund the department of defense—a monumental figure [1]. Cardiovascular disease (CVD) remains the largest driver of health care costs in the United States. By 2030 43.9 per cent of Americans are projected to have some form of CVD, driving a more than $550 billion increase in the total costs of CVD care annually [2]. However, despite how much the United States spends on health care, the American health enterprise continues to rank in the bottom half of developed nations in overall public health [3-5]. The passage of the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015 (MACRA) was meant to be the dawn of a new day in healthcare to help rectify these disparities. For graduate medical education trainees transitioning from practicing in sheltered residency and fellowship environments into independent practice, understanding these new healthcare delivery models will be vital to providing high-quality care to patients.