CMS declares extra opportunities for clinicians to merge with innovative care approaches

The Centers for Medicare & Medicaid Services (CMS) today has declared additional opportunities for clinicians to merge with Advanced Alternative Payment Models (APMs) which is established by the CMS Innovation Center to improve care and possibly gain an incentive payment under the Quality Payment Program created through the MACRA (Medicare Access and CHIP Reauthorization Act of 2015). Clinicians are rewarded by the Quality Payment Program with enough participation in Advanced APMs that align incentives for high-quality, patient-centered care. Today’s declaration will expand the benefits of high-quality, coordinated care to more Medicare beneficiaries by providing more clinicians the opportunity to engage in these models.

CMS is declaring that it hopes to re-open applications for latest practices and payers in the Comprehensive Primary Care Plus (CPC+) model and new participants in the Next Generation ACO model for the 2018 performance year. Moreover, CMS is also keen to declare that the Innovation Center’s Oncology Care Model with 2-sided risk will now be available in the year of 2017, which will qualify the model as an Advanced APM starting in the 2017 performance year.

In the year of 2017, clinicians might earn a 5% incentive payment through enough participation in the following Advanced APMs under the Quality Payment Program:

• Comprehensive ESRD Care Model (non-LDO arrangement)
• CPC+
• Next Generation ACO Model
• Comprehensive ESRD Care Model (Large Dialysis Organization (LDO) arrangement)
• Medicare Shared Savings Program ACOs - Track 2
• Medicare Shared Savings Program ACOs - Track 3
• Oncology Care Model (two-sided risk arrangement)

​We expect that clinicians might also earn the incentive payment through sufficient participation in the following models in the year of 2018:

• ACO Track 1+
• Advancing Care Coordination through Episode Payment Models Track 1 (CEHRT track)
• Comprehensive Care for Joint Replacement Payment Model (Certified Electronic Health Record Technology (CEHRT) track)
• New voluntary bundled payment model

These above mentioned lists will sustain to change or modify and grow as more models are proposed and established in partnership with the Physician-Focused Payment Model Technical Advisory Committee and clinician community.
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“CMS anticipates that by the 2018 performance period, 25% of clinicians in the Quality Payment Program will gain incentive payments by being an active part of these advanced models with the help of these additional new opportunities,” stated Dr. Patrick Conway, Deputy Administrator of CMS.
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For further information, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-10-25.html ​