- The CMS Innovation Center announced Tuesday new participation opportunities for Advanced Alternative Payment Models (APMs).
- The effort seeks to increase the amount of providers that have a chance at receiving a 5% payment incentive under the Quality Payment Program the MACRA implementation rule recently established.
- The agency expects to re-open applications for the Comprehensive Primary Care Plus (CPC+) model as well as the Next Generation Accountable Care Organization (ACO) model for 2018. The center's Oncology Care model will be available as an APM with two-sided risk beginning in 2017.
The MACRA implementation rule, which was released earlier this month, finalized two quality-based payments paths: APMs and the Merit-based Incentive Payment System (MIPS). One of the significant changes from the April proposed rule was an increase in the amount of providers who can qualify to participate in the APM path.
However, the final rule was also criticized for not including some of the recommendations made during the comment period, such as further opportunities for smaller practices. At least one association said it was disappointed that many physicians, especially those in patient-centered medical homes, would still be unable to participate in an APM. "Opportunities to enter other such value-based models remain limited,” said Boyd Buser, president of the American Osteopathic Association.
CMS said it will continue to accept comments and evolve the final QPP rule, and the new announcement makes good on that approach. The lists of available APMs "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," CMS said in a prepared statement.
The APM paths now available for the 2017 performance year are:
- Comprehensive ESRD Care Model (Large Dialysis Organization (LDO) arrangement);
- Comprehensive ESRD Care Model (non-LDO arrangement);
- Medicare Shared Savings Program ACOs - Track 2 and Track 3;
- Next Generation ACO Model; and
- Oncology Care Model (two-sided risk arrangement).
For 2018, CMS anticipates incentive payments through participation in:
- ACO Track 1+;
- A new voluntary bundled payment model;
- Comprehensive Care for Joint Replacement Payment Model (Certified EHR Technology (CEHRT) track); and
- Advancing Care Coordination through Episode Payment Models Track 1 (CEHRT track).