CMS: Number of docs in APMs doubles in 2018, but challenges for smaller practices remain

Medicine Money
More doctors participated in advanced payment models such as MIPS in 2018 compared to 2017, Centers for Medicare & Medicaid Services Administrator Seema Verma announced. (Getty/utah778)

The number of doctors participating in advanced payment models (APMs) nearly doubled in 2018 to 183,306 compared to 99,076 doctors participating in 2017, according to new data.

Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma attributed the increase to more opportunities to participate in such models last year, especially via affordable care organizations (ACOs).

“I am excited about this progress, as it is a critical indicator we are succeeding in our goal of maximizing participation in [Merit-based Incentive Payment System] APMs and Advanced APMs,” Verma wrote in a blog post Thursday announcing the increase. “Flexibilities we introduced led to 98% of eligible clinicians participating in MIPS in 2018, up from 95% in 2017.”

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Nearly 90% of clinicians in small practices participated in 2018, a nine-percentage point boost from 2017, Verma added.

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Verma touted changes made to the Physician Fee Schedule to improve flexibility for the use of APMs such as increases to the Medicare patient count, which meant “fewer clinicians in small practices were required to participate, but results show they elected to do so anyway.”

The agency has also offered technical assistance such as a virtual group that enables doctors in smaller practices to share information. 

But Verma also conceded CMS still gets complaints from doctors in small practices that they are getting negative payments under MIPS.

It remains unclear how the clinicians are faring financially under MIPS. For the 2017 performance year, more than 90% of the doctors who participated in the program got a small pay bump.

RELATED: Vast majority of doctors will get a pay bump under MIPS, but it won’t be much

CMS unveiled a major change to the Medicare Shared Savings Program that oversees ACOs. The program now makes physician- and hospital-led ACOs take on financial risk at a faster rate than the previous program.

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