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CMS Publishes List of Alternative Payment Models

The Centers for Medicare & Medicaid Services (CMS) has published a comprehensive table listing the agency’s alternative payment models (APMs) as of January 2018.

The table identifies which APMs are designated as Advanced APMs under the Quality Payment Program (QPP), the physician payment system required by the Medicare Access and CHIP Reauthorization Act of 2015. The Advanced APM track:

  • requires patients to use certified electronic health record technology;
  • provides payment for services based on quality measures comparable to those used in the Merit-based Incentive Payment System (MIPS) quality performance category; and
  • requires participants to bear a financial risk that is greater than nominal or to be designated as a Medical Home Model under CMS Innovation Center authority.

The table also notes which programs are considered MIPS APMs, which are responsible for the cost and quality of care provided to Medicare beneficiaries. Most Advanced APMs also are MIPS APMs; if a program does not qualify as an Advanced APM, it will be assessed as a MIPS APM.

America’s Essential Hospitals has established a resource page dedicated to the QPP. Visit this page regularly for new and updated information.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Emily Schweich is a communications associate for America's Essential Hospitals.