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Advanced APM Timeline – MACRA Monday

Posted on December 5, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Last week we posted about the APM Expansion in MACRA and the new PTAC Committee. Today we’ll dive into the timelines for APMs. They can get pretty confusing, so hopefully after you read this post you’ll have a better idea on how the APM timelines work.

Before we dive into the timelines, I also wanted to make a quick note of the benefits related to participating in an APM. The APM benefits really didn’t change in the MACRA final rule so our previous post on Advanced APM incentives is still accurate as well.

As we noted before, participating as an advanced APM provides incentives on top of whatever rewards are part of your original APM agreement. Under MACRA, you just get an extra 5% bonus on top of your pre-MACRA rewards for being in an APM. Here are the 3 main benefits of participating as an advanced APM under MACRA:
advanced-apm-benefits

As far as reporting as an Advanced APM, CMS will take three “snapshots” on March 31, June 30, and August 31 in order to determine which eligible providers are eligible as an Advanced APM and meet the thresholds to become a Qualified APM participant.

Here’s the official timeline details from CMS:

cms-apm-determination-timeline

At point B, the snapshots are taken to determine eligibility and at point D in the graph above, eligible providers will be notified of their APM eligibility. Yes, this is a very compressed timeline, so it behooves you to get started early. Remember that if you don’t qualify as an Advanced APM, then you still have to participate in MIPS.

The timeline for paying the 5% reward for being part of a qualified Advanced APM is still 2019 for reporting year 2017. 2018 reporting year will determine payouts for 2020 and so forth. That’s no change from the proposed MACRA rule.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

APM Expansion and New PTAC Committee – MACRA Monday

Posted on November 28, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Most of the general details about APMs was changed in the final rule (See our previous post about APMs and whether you should take part in an APM or MIPS within MACRA). However, if you want to dive into the details of APMs, then check out this CMS webinar and slides that dive into the APM program. One thing that didn’t change much yet is the types of programs that counted as possible advanced APMs:

  • Shared Savings Program (Tracks 2 and 3)
  • Next Generation ACO Model
  • Comprehensive End Stage Renal Disease Care Model (Two-Sided Risk Arrangements)
  • Comprehensive Primary Care Plus (CPC+)
  • Oncology Care Model (OCM) (two-sided risk track)

However, as CMS mentioned previously, their goal is to get more and more people involved in the APM program. As part of that effort, a number of other programs are likely to be eligible as an advanced APM in 2018:

  • Comprehensive Care for Joint Replacement (CJR) Payment Model (CEHRT)
  • Advancing Care Coordination through Episode Payment Models Track 1 (CEHRT)
  • ACO Track 1+
  • New Voluntary Bundled Payment Model
  • Vermont Medicare ACO Initiative (as part of the Vermont All-Payer ACO Model)

In fact, some of these might even be available in 2017. The MACRA final rule also created a new committee called the PTAC (Physician-Focused Payment Model Technical Advisory Committee). This committee will accept suggestions on other programs that should be considered an advanced APM. Then, they make recommendations to the HHS secretary on which programs should be added as Advanced APMs.

All updates on programs that qualify as an Advanced APM will be available on the CMS Quality Payment Program (MACRA) website.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.