What are Alternative Payment Models (APMs)?
An Alternative Payment Model (APM) is a payment approach that gives added incentive payments to provide high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population.
What are Advanced APMs?
Advanced APMs are one of the two Quality Payment Program (QPP) tracks used by the Centers for Medicare and Medicaid Services (CMS) to determine Medicare payment adjustments for eligible clinicians under the QPP. The Advanced APMs path is most relevant for clinicians who continue to focus on and innovate in delivering coordinated, efficient and transformative care for patients.
Clinicians who meet the criteria for participation in an Advanced APM will not be subject to payment adjustments under MIPS, but will instead be eligible to receive the APM Incentive Payment, equal to 5% of a clinician’s Medicare Part B billed services from the previous year.
APMs that are meet the criteria to be an Advanced APMs in 2018 are listed below:
- Bundled Payments for Care Improvement Advanced Model (BPCI Advanced)
- Comprehensive ESRD Care (CEC) - Two-Sided Risk
- Comprehensive Primary Care Plus (CPC+)
- Medicare Accountable Care Organization (ACO) Track 1+ Model
- Next Generation ACO Model
- Shared Savings Program - Track 2
- Shared Savings Program - Track 3
- Oncology Care Model (OCM) - Two-Sided Risk
- Comprehensive Care for Joint Replacement (CJR) Payment Model (Track 1- CEHRT)
For more information: