CMS touts growth of APMs as move continues to value-based payment

moneyjar
CMS continues shift to value-based payment models.

More than 359,000 clinicians across the country will participate in four Alternative Payment Models (APMs) this year, as the Centers for Medicare & Medicaid Services continues the move to value-based payment models.

The numbers include 2,893 primary care practices that will participate in the Comprehensive Primary Care Plus (CPC+) Model, the federal agency said in an announcement Wednesday.

“By listening to physicians and engaging them as partners, CMS has been able to develop innovative payment reforms that bring physicians back to the core practice of medicine—caring for the patient,” said CMS Acting Administrator Andrew Slavitt, who is leaving his job Friday as the new Trump administration takes over.

New Whitepaper

CMS Doubles Down on CAHPS and Raises the Bar on Member Experience

A new CMS final rule will double the impact of CAHPS and member experience on a Medicare plan’s overall Star Rating. Learn more and discover how to exceed member expectations and improve Star Ratings in this new whitepaper.

The APMs also include three accountable care organizations—the Medicare Shared Savings Program, the Next Generation ACO Model and the Comprehensive End-Stage Renal Disease Care Model.

RELATED: Medicare ACO explosion: CMS boasts 570 participants for 2017

The CMS initiatives offer opportunities for doctors and other clinicians to participate in Advanced APMs under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

MACRA offers two Medicare payment options for doctors: Advanced APMs and the Merit-based Incentive Payment System (MIPS).

APMs require providers to assume risk, but also offer greater reward in terms of reimbursement. The agency expects most physicians will initially participate under MIPS, with more practices having the opportunity to participate in Advanced APMs in future years. In this first year of MACRA, CMS expects only 10% of clinicians will be in an Advanced APM.  However, the agency projects that number to grow to 25% by the 2018 performance year, making practices eligible to earn incentive payments under MACRA.

The participation in Medicare APMs is a clear signal that the shift to value-based payment and care delivery will continue to grow under MACRA, Joe Damore, vice president at Premier, a healthcare improvement company that has worked with 23 accountable care organizations that participate in CMS programs, said in an announcement.

With CPC+, an advanced primary care medical home model, CMS is partnering with 54 payers in 14 regions. In 2017, the program will include more than 13,000 clinicians in those 2,893 practices. CMS will continue the program into 2018, with Round 2 funding.

For more information about CPC+, CMS has a fact sheet (PDF) available.

Suggested Articles

Blues plans have reportedly agreed to a $2.7 billion antitrust settlement.

Premera Blue Cross will pay $6.9 million to HHS over a data breach six years ago that exposed 10 million people's health information.

HHS and the FDA finalized a rule that enables states to seek approval to re-import certain drugs from Canada for a cheaper price.