What are Advanced Alternative Payment Models (APMs)?
Advanced Alternative Payment Models (APMs) are a track of the Quality Payment Program that offer an incentive for achieving threshold levels of payments or patients. Therefore, if you achieve these thresholds, you become a Qualifying APM Participant (QP) and you are excluded from the MIPS reporting requirements and payment adjustment.
Advanced APMs are advanced alternative payment models that meet these 3 criteria:
- Requires participants to use certified EHR technology;
- Provides payment for covered professional services based on quality measures comparable to those used in the MIPS quality performance category; and
- Either: (1) is a Medical Home Model expanded under CMS Innovation Center authority OR (2) requires participants to bear a significant financial risk.
Advanced APMs offer potential benefits for providers, including a 5% bonus. For the reporting year, 2019, these are the Advanced APMs:
- Comprehensive Primary Care Plus (CPC+)
- Medicare Accountable Care Organization (ACO)
- Next Generation ACO Model
- Vermont Medicare ACO Initiative
- Maryland All-Payer Model
- Maryland Total Cost of Care Model
- Oncology Care Model (OCM)
- Comprehensive Care for Joint Replacement (CJR)