CMS Predicts Qualifying APM Participants

Physicians need wonder no more whether they’ll don the honor of Qualifying Participant (QP) in an Advanced Alternate Payment Model (APM), this year. The Centers for Medicare & Medicaid Services (CMS) announced over the weekend predictive QP status for 2017 Advanced APMs.
CMS predicts nearly 100 percent of eligible clinicians in the following Advanced APMs will be QPs in this first year of the new Quality Payment Program and qualify for the 5 percent APM incentive payment in 2019:

Comprehensive ESRD Care – two sided risk
Comprehensive Primary Care Plus
Next Generation Accountable Care Organization Model
Medicare Shared Savings Program – tracks 2 and 3

This fortuitous prediction is based on administrative claims with dates of service between Jan. 1, 2016, and Aug. 31, 2016, that were processed by Nov. 30, 2016. Actual QP determinations will be based on claims data taken from March 31, June 30, and August 31 “snapshots” of the relevant performance year.

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Renee Dustman
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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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