CMS intends to update its list and release its list for Medicare Advantage and other health plans later this year, according to the American Hospital Association.
CMS selected the Medicaid programs based on entries the payers submitted earlier this year. To determine qualification for the all-payer options during a given performance year, state Medicaid agencies, Medicare health plans and payers in CMS multipayer models can submit details about their payment model to the agency.
Here are the six Medicaid payment arrangements named as advanced APMs for 2019:
1. Massachusetts’ accountable care partnership plan, managed care
2. Ohio’s episode-based payments model, fee-for-service and managed care
3. Tennessee’s retrospective episodes of care model, managed care
4. Washington’s Community Health Plan of Washington, managed care (Population-based payment model, adult/blind or disabled, option B: Individual community health center risk)
5. Washington’s Community Health Plan of Washington, managed care (Population-based payment model, family/SCHIP, stop‐loss option B)
6. Washington’s Community Health Plan of Washington, managed care (Population-based payment model, family/SCHIP, stop‐loss option C)
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