New Practices Given Opportunity to Join APM

New Practices Given Opportunity to Join APM

The ink on the Merit-based Incentive Payment System (MIPS) and Alternate Payment Model (APM) final rule is barely dry and already the Centers for Medicare & Medicaid Services (CMS) is making good on their promise to establish additional opportunities for eligible clinicians to join APMs.
CMS announced today that it expects to re-open applications for new practices and payers in the Comprehensive Primary Plus (CPC+) model and new participants in the Next Generation Model Accountable Care Organization (ACO) model for the 2018 performance year.
In addition, the Innovation Center’s Oncology Care Model will now be available in 2017, and will qualify as an Advanced APM.
Under the Quality Payment Program, clinicians may earn a 5 percent incentive payment in 2019 through sufficient participation during performance year 2017 in the following Advanced APMs:

  • Comprehensive ESRD Care Model (Large Dialysis Organization (LDO) arrangement)
  • Comprehensive ESRD Care Model (non-LDO arrangement)
  • CPC+
  • Medicare Shared Savings Program ACOs – Track 2 + 3
  • Next Generation ACO Model
  • Oncology Care Model (two-sided risk arrangement)

CMS anticipates that clinicians may also earn a 5 percent incentive payment in 2020 through sufficient participation during performance year 2018 in the following models:

  • ACO Track 1+
  • New voluntary bundled payment model
  • Comprehensive Care for Joint Replacement Payment Model (Certified Electronic Health Record Technology (CEHRT) track)
  • Advancing Care Coordination through Episode Payment Models Track 1 (CEHRT track)

CMS believes these lists will continue to change and grow as more models are proposed and developed in partnership with the clinician community and the Physician-Focused Payment Model Technical Advisory Committee.
For 2017, CMS estimates 433 Shared Savings Program ACOs will submit on behalf of 140,341 participants and 18 Next Generation ACOs will submit on behalf of 24,144 participants.
“With these new opportunities, CMS expects that by the 2018 performance period, 25 percent of clinicians in the Quality Payment Program will earn incentive payments by being a part of these advanced models,” said Dr. Patrick Conway, Deputy Administrator of CMS.
For more information, please visit CMS’ Innovation Center.

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Renee Dustman, BS, AAPC MACRA Proficient, is managing editor - content & editorial at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. Renee has more than 30 years' experience in journalistic reporting, print production, graphic design, and content management. Follow her on Twitter @dustman_aapc.

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