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MACRA knowledge hub

Learn about the MACRA proposed rule, MIPS, and alternative payment models. Discover how you can be rewarded for providing better, lower-cost, patient-centered care while avoiding program penalties.

Understanding Alternative Payment Models (APMs)

What is an Advanced APM?

Advanced APMs are a subset of APMs.  Advanced APM practices earn more for taking on risk related to their patient outcomes. A 5% incentive payment is earned by taking patient care improvements to the next level and taking on risk through an Advanced APM. 

Determining APM Status 

By now, providers who are part of an Advanced APM should have received a status letter from CMS.  
APMs are exempt from MIPS payment adjustments and qualify for a 5 percent Medicare Part B incentive payment. To qualify for incentive payments, clinicians would have to receive enough of their payments or see enough of their patients through Advanced APMs. 
For 2017, clinicians must have a minimum of 25% of their revenue from Medicare come through eligible APMs and see 20% of their Medicare patients through an Advanced APM.

2017 approved Advanced APMs include:

  • Next Generation ACO
  • Comprehensive Primary Care Plus (CPC+)
  • Medicare Shared Savings Program (MSSP) Tracks 2 and 3
  • Oncology Care Model with two-sided risk
  • Comprehensive ESRD Care

 

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