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359K Clinicians to Join CMS Alternative Payment Models in 2017

The MSSP, Next Generation ACO model, Comprehensive End-Stage Renal Disease model, and the CPC+ program will all see new participants this year.

About 359,000 clinicians will join four CMS alternative payment models in 2017, CMS reported

Source: Thinkstock

- CMS recently announced that the federal agency selected over 359,000 clinicians to participate in four of the federal agency’s alternative payment models in 2017.

The new participants will be joining the Medicare Shared Savings Program (MSSP), Next Generation Accountable Care Organization (ACO) model, Comprehensive End-Stage Renal Disease Care model, and the Comprehensive Primary Care Plus (CPC+) program.

“By listening to physicians and engaging them as partners, CMS has been able to develop innovative payment reforms that bring physicians back to the core practice of medicine – caring for the patient,” stated Andy Slavitt, CMS Acting Administrator. “By reducing regulatory burden and paying for quality, CMS is offering solutions that improve the quality of services our beneficiaries receive and reduce costs, to help ensure the Medicare program is sustainable for generations to come.”

Out of the total number of new participants, the federal agency highlighted that the MSSP, Next Generation ACO model, and Comprehensive End-Stage Renal Disease Care model will see 572 new ACOs participating this year.

The MSSP, specifically, will contain a total of 480 ACOs in 2017, with 99 new participants and 79 renewing participants in 2017. The number of MSSP ACOs is up 47 participants since January 2016.

CMS also expects MSSP participation to increase in the next year with the launch of an additional track in 2018. The MSSP Track 1+ model should draw in more participants, especially small and rural providers, because the track contains limited downside financial risk, but still qualifies as an Advanced Alternative Payment Model under the Quality Payment Program.

Applications for the new MSSP track are scheduled to open in May.

The Next Generation ACO model will also get 28 new participants in 2017, CMS added. The ACO model, which contains higher levels of financial risk than the MSSP, will have a total of 45 ACOs.

Like the MSSP, the Next Generation ACO model could see a boost in participation by 2018. CMS recently announced that it will reopen applications for 2018 from January to February 2017. The opportunity will allow more eligible clinicians to qualify as Advanced Alternative Payment Model participants.

The re-opened application opportunity, however, will be the final round of Next Generation ACO model applications and those selected to participate will not be able to defer.

In terms of the Comprehensive End-Stage Renal Disease Care model, CMS reported that the model will gain 24 participants, bringing the total to 47 participants in 2017.

Model participants that are in the large dialysis organization structure and the non-large dialysis organization structure with two-sided financial risk will be eligible to earn value-based incentive payments under the Quality Payment Program’s Advanced Alternative Payment Model track in 2017.

While ACOs in the three programs have a wide range of financial risk options, CMS noted that 131 ACOs will be in a risk-bearing track in the coming year.

The federal agency intends for more alternative payment model participants to increase their financial risk levels to make providers more accountable for high-quality, affordable care. For example, MSSP Track 1 ACOs, which are upside risk only, must move into a risk-bearing track after two agreement periods.

Similarly, MSSP Track 1+ ACOs will only be allowed to join the limited downside financial risk structure for one three-year agreement period.

Additionally, CMS reported that the non-ACO CPC+ program will add 2,893 primary care practices in 2017. In the primary care alternative payment model’s first round, the federal agency will collaborate with 54 payers in 14 regions to provide value-based reimbursement to the participating practices.

Like the Next Generation ACO model, though, CMS also re-opened CPC+ applications for 2018 participation to boost the number of Advanced Alternative Payment Model providers. Interested practices will be able to apply for the alternative payment model in late spring or early summer of 2017.

Based on the new 359,000 alternative payment model participants and application opportunities, CMS intends for 25 percent of eligible clinicians in the Quality Payment Program to be part of an Advanced Alternative Payment Model in 2018.

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