CMS offers more ways for physicians to participate in APMs

Physicians who want to take advantage of the Advanced Alternative Payment Models (APMs), which may allow them to earn a 5 percent incentive payment under MACRA, will have more opportunities to participate in that payment program.

The Centers for Medicare & Medicaid Services today announced additional opportunities for physicians and other clinicians to join APMs--one of the two payment branches offered under its Quality Payment Program (QPP) created through the Medicare Access and Chip Reauthorization Act (MACRA).

CMS unveiled the final rule to implement MACRA and institute a new Medicare payment system on October 14. Under the program, doctors can participate in APMs or the Merit-based Incentive Payment System.

With expanded opportunities to participate in APMs, CMS expects that by the 2018 performance period, 25 percent of clinicians in the QPP will earn incentive payments under one of these advanced models, Patrick Conway, M.D., deputy administrator at CMS, said in the announcement. “We’re striving to see more Medicare patients benefit from better care when they visit their doctor for a knee replacement, receive cancer treatment, or have a coordinated care team manage their complex conditions,” he said.

The agency announced the following steps to expand participation in APMs:

  • It expects to re-open applications for new practices and payers in the Comprehensive Primary Care Plus (CPC+) model and new participants in the Next Generation Accountable Care Organization model for the 2018 performance year.
  • It will make the Innovation Center’s Oncology Care Model with two-sided risk available in 2017, which will qualify the model as an advanced APM beginning in the 2017 performance year.

Therefore, for 2017, physicians can now participate in the following seven APMs:

  • Comprehensive ESRD Care Model (Large Dialysis Organization (LDO) arrangement)
  • Comprehensive ESRD Care Model (non-LDO arrangement)
  • CPC+
  • Medicare Shared Savings Program ACOs - Track 2
  • Medicare Shared Savings Program ACOs - Track 3
  • Next Generation ACO Model
  • Oncology Care Model (two-sided risk arrangement)

CMS plans to expand the APMs further in 2018 to include:

  • ACO Track 1+
  • New voluntary bundled payment model
  • Comprehensive Care for Joint Replacement Payment Model (Certified Electronic Health Record Technology (CEHRT) track)
  • Advancing Care Coordination through Episode Payment Models Track 1 (CEHRT track)

CMS said the lists of APMs will continue to change and grow as more models are proposed and developed. So far, physicians have had a mixed reaction to MACRA. It is a complicated system spelled out in almost 2,400 pages of the final rule.