In modern healthcare, more attention is being paid lately to the level of quality we provide to our patients, rather than emphasising how much the quantity care is being doled out to them.
Definition of APMs:
“An APM is a payment approach that gives added incentive payments to provide high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population.”
For example, We want to encourage doctors to avoid things like x-rays or lab tests that may not actually be needed from the perspective of an objective medical professional, but were ordered to cover the doctor and support the diagnosis and treatment plan.
Advanced APMs are a subset of APMs, and let practices earn more for taking on some risk related to their patients’ outcomes. You may earn a 5% incentive payment by going further in improving patient care and taking on risk through an Advanced APM.
Examples of Advanced APMS for 2017, according to a recent report from the U.S. government’s Quality Payment Program include:
- Comprehensive ESRD Care (CEC) – Two-Sided Risk.
- Comprehensive Primary Care Plus, also known as CPC+.
- Next Generation ACO Model.
- Shared Savings Program – Track 2.
- Shared Savings Program – Track 3.
- Oncology Care Model (which is a two-sided risk arrangement.
You’ll want to check into the details of these advanced APMs to determine which would be the best fit for your particular medical organization. What’s more, you will need to research and determine how much time and resources it will take your organization to meet the quality metric reporting requirements, adjust how you provide aftercare to patients.
As you check out the overview of a specific advanced APM that fits your practice, you will see the details on how to apply to it. A clinician becomes a qualified provider by participating in one of the APMs.
Overview of 2017 APM Models:
You’ll want to learn how you can join or earn the Advanced APM incentive. You do so by participating in one of these APMs. Once you have joined an APM, you can expect to earn the 5% incentive payment in 2019 for Advanced APM participation in 2017, so long as you meet the following criteria: You must receive 25% of your Medicare Part B payments through an Advanced APM, or you will treat at least 20% of your Medicare patients through an Advanced APM.
Keep in mind that there can be penalties if you do not meet all the requirements. Otherwise, you will need to turn in your data under the MIPS program, or you face a 4% decrease in your 2019 payment adjustment.
“Becoming more familiar with the Alternative Payment Models will help your medical organization thrive over the coming years as an emphasis on quality of care becomes more pronounced.”
Feel free to reach us +1(302) 613-1356 for more information and we are happy to help you out.