CMS announces additional opportunities for clinicians to join innovative care approaches under the Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) announced new opportunities for clinicians to join Advanced Alternative Payment Models (APMs) developed by the CMS Innovation Center to improve care and potentially earn an incentive payment under the Quality Payment Program created through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Quality Payment Program rewards clinicians with sufficient participation in Advanced APMs that align incentives for high-quality, patient-centered care. By giving more clinicians the opportunity to participate in these models, today’s announcement will extend the benefits of high-quality, coordinated care to more Medicare beneficiaries.

CMS is announcing that 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 (ACO) model for the 2018 performance year. In addition, CMS is announcing that the Innovation Center’s Oncology Care Model with two-sided risk will now be available in 2017, which will qualify the model as an Advanced APM beginning in the 2017 performance year.

In 2017, under the Quality Payment Program, clinicians may earn a 5 percent incentive payment through sufficient participation in the following Advanced 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)

In 2018, CMS anticipates that clinicians may also earn the incentive payment through sufficient participation in the following models:

  • 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)

These lists 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.

For more information, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-10-25.html 


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