An Alternative Payment Model (APM) is an approach to payment, developed in partnership with clinician communities, providing incentives to clinicians to provide high-quality and cost-effective care. Clinicians must apply to participate in APMs.
Advanced APMs are a subset of APMs and let practices earn more for taking on more risk. The are 9 approved Advanced APMs:
- Comprehensive ESRD Care (CEC) – Large Dialysis Organization (LDO)
- Comprehensive ESRD Card – Non-LDO
- Comprehensive Primary Care Plus (CPC+)
- Next Generation ACO Model
- Shared Savings Program – Track 2
- Shared Savings Program – Track 3
- Oncology Care Model (two-sided risk arrangement)
- Bundled Payments for Care Improvement Advanced Model (BPCI Advanced)
- Medicare Accountable Care Organization (ACO) Track 1+ Model
Clinicians who participate successfully in an Advanced APM are exempt from MIPS reporting and have the potential to earn a 5% Medicare incentive payment during 2019 through 2024. Clinicians can use the APM Lookup Tool to check their Qualifying APM Participant (QP) status.
Each APM and Advanced APM has unique requirements, please contact your APM program coordinator to discuss program and technology requirements.