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CMS Expands Opportunities Under the Quality Payment Program

CMS is offering clinicians additional opportunities to join Advanced Alternative Payment Models under the Quality Payment Program within MACRA to enhance care and earn additional incentive payments.

“The CMS Innovation Center, which the Affordable Care Act created, takes best practices from physicians and other clinicians and promotes them across the nation,” Andy Slavitt, acting administrator of CMS, said in a news release. “Thanks to the bipartisan MACRA, more clinicians and their patients will benefit from being a part of these models. That’s good for the future of Medicare, the health of beneficiaries, and the satisfaction of clinicians with their work.”

Applications for new rounds of two CMS Innovation Center models — the Comprehensive Primary Care Plus (CPC+) model and the Next Generation Accountable Care Organization (ACO) model — will open beginning in January 2017. By the 2018 performance period, CMS expects 25% of clinicians in the Quality Payment Program to be a part of the advanced models and qualify to earn incentive payments.

Physicians who sufficiently participate in the following Advanced Alternative Payment Models (APMs) may earn a 5% incentive payment for the 2017 performance year:

• Comprehensive end-stage renal disease (ESRD) care model, large dialysis organization arrangement;
• comprehensive ESRD care model, non-large dialysis organization, two-sided risk arrangement;
• CPC+;
• Medicare shared savings program, track 2;
• Medicare shared savings program, track 3;
• ·next generation Accountable Care Organization (ACO) model; and
• ·oncology care model.

Similarly, physicians who sufficiently participate in the following new and existing models may also earn incentive payments for the 2018 performance year:

• Medicare ACO track 1+ model;
• ·new voluntary bundled payment model;
• comprehensive care for joint replacement payment model; and
• advancing care coordination through episode payment models track 1.

As more models are developed, these lists will continue to evolve.

“We are excited to build on the progress of comprehensive primary care, the foundation of a better health system,” Patrick Conway, acting deputy administrator of CMS, said in the release. “Our Next Generation ACO model is the future of accountable care where providers take on full accountability for total cost of care and quality for a population of patients. These models allow doctors and other clinicians to practice the way they want to, including spending more time with patients, and provide coordinated, patient-centered care to all beneficiaries.”