CMS adds advanced APM opportunities under MACRA

CMS is officially reopening applications for physicians to join two value-based care models in 2018 — both of which qualify as advanced alternative payment models under the Medicare Access and CHIP Reauthorization Act.

The advanced APM is the potentially more lucrative of two tracks under MACRA's Quality Payment Program, which will determine Medicare physician fees beginning in 2019. Physicians participating in advanced APMs can earn a lump sum bonus of up to 5 percent on Medicare payments.

The new offerings announced Thursday include opportunities to join CMS' Comprehensive Primary Care Plus model or its Next Generation ACO model for the 2018 performance year. With the opportunities added Thursday, CMS believes one-quarter of physicians will be part of advanced APMs by 2018.

American Medical Association President Andrew Gurman, MD, commended CMS' announcement. "By being part of these models, physicians will have more time with patients and more flexible payments to support care coordination and improvements in access and quality," Dr. Gurman said in a statement. "This will result in healthier patients and more satisfied physicians, a win-win that is a good holiday present for everyone."

This is the second time since announcing the final rule CMS has added opportunities to join advanced APMs. In October, the agency added the Oncology Care Model with two-sided risk as a qualifying model for the 2017 performance year and hinted it would reopen applications for the Next Generation ACO and CPC+ models. CMS plans to continue to add opportunities for participation in existing programs, as well as develop new models that qualify.

The following models are considered advanced APMs for the 2017 performance year.

  • Comprehensive End Stage Renal Disease Care Model, Large Dialysis Organization and non-LDO two-sided risk arrangements
  • CPC+
  • Medicare Shared Savings Program ACO, Tracks 2 and 3
  • Next Generation ACO
  • Oncology Care Model, two-sided risk arrangement

CMS will add the following models as advanced APMs in 2018.

  • Medicare ACO Track 1+
  • New voluntary bundled payment model
  • Comprehensive Care for Joint Replacement Payment Model, Certified EHR Technology track
  • Advancing Care Coordination through Episode Payment Models Track 1, CEHRT track

 

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