Advanced Alternative Payment Models

Reducing Barriers to MIPS, Advanced APMs Could Promote Participation

October 23, 2023 - Reducing barriers to Advanced Alternative Payment Model (APM) participation for physicians in rural areas could help promote value-based care and control rising Medicare spending, according to research from the US Government Accountability Office (GAO). Both Medicare enrollment and spending are expected to increase in the coming years, highlighting...

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How Vermont’s All-Payer ACO Model Paves the Way for Value-Based Care

by Victoria Bailey

As its name states, the Vermont All-Payer Accountable Care Organization (ACO) Model is an arrangement that incorporates patients with both private and public healthcare coverage, but what makes this model so appealing to providers? Is this...

NAACOS: Medicare Payment Incentives Favor Clinicians in Fee-For-Service

by Victoria Bailey

Medicare payment incentives favor clinicians participating in fee-for-service models rather than those in advanced alternative payment models (APMs), according to the National Association of...

Bipartisan Bill Calls for Extended Value-Based Payment Incentives

by Victoria Bailey

US Senators John Barrasso (R-WY) and Sheldon Whitehouse (D-RI) have introduced a bipartisan bill that would extend value-based payment incentives for healthcare providers participating in...

Bipartisan Letter Requests Extended Value-Based Payment Incentives

by Victoria Bailey

More than 40 House lawmakers have asked congressional leaders to support value-based payment incentives and extend the 5 percent bonus for Alternative Payment Model (APM) participation. In a...

Healthcare Orgs Urge Congress to Improve Value-Based Care Participation

by Victoria Bailey

Healthcare groups have called on Congress to extend incentive payments, revise threshold requirements, and expand regulatory waivers to address concerns about the Medicare Access and CHIP...

NAACOS, AMA Ask Congress to Extend Advanced APM Incentive Payments

by Victoria Bailey

More than 800 accountable care organizations (ACOs) and healthcare associations, including the National Association of ACOs (NAACOs) and American Medical Association (AMA), have asked Congress to...

CMS Proposes Quality Payment Program Updates in CY23 PFS Rule

by Victoria Bailey

In its recently released calendar year (CY) 2023 Medicare Physician Fee Schedule (PFS) proposed rule, CMS proposed Quality Payment Program (QPP) changes to the Merit-based Incentive Payment System...

Breaking Down Common CMS Value-Based Payment Programs

by Victoria Bailey

Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from...

NAACOS, AMA Urge Congress to Boost Value-Based Care, APM Incentives

by Victoria Bailey

A group of eight healthcare organizations, including the American Medical Association (AMA) and National Association of ACOs (NAACOS), have asked Congress to increase their efforts in promoting...

Why Rural Providers Aren’t Transitioning to Alternative Payment Models

by Jacqueline LaPointe

A smaller percentage of providers in rural or health professional shortage areas eligible to participate in Advanced Alternative Payment Models (APMs) did partake in the Quality Payment Program track compared to providers not located in...

Deadline to Provide Billing Info for Advance APM Bonus Approaches

by Jacqueline LaPointe

UPDATE 11/20/2020: CMS has extended the deadline to update billing information for APM incentive payments to December 13, 2020.  Eligible clinicians who CMS has notified as having missing billing...

CMS Releases Initial Quality Payment Program Results for 2019

by Jacqueline LaPointe

Eligible clinicians overwhelmingly participated in the Quality Payment Program despite facing challenges caused by the COVID-19 pandemic, according to preliminary data from CMS. CMS announced in a...

Most ACOs Worried About Rising Advanced APM Thresholds Next Year

by Jacqueline LaPointe

A new survey confirms a growing concern among accountable care organizations (ACOs) – most ACOs are unlikely to meet rising participation thresholds for MACRA’s Advanced Alternative Payment...

Telehealth Reimbursement Just for Value-Based Providers Post-COVID?

by Jacqueline LaPointe

The Medicare Payment Advisory Commission (MedPAC) is the latest group to weigh telehealth reimbursement expansions after the COVID-19 pandemic. In a meeting held virtually last week, MedPAC analysts...

Lawmakers Propose Changes to MACRA to Boost ACO, APM Participation

by Jacqueline LaPointe

A bipartisan bill introduced late last week aims to increase alternative payment model (APM) participation by making “commonsense changes” to the Medicare Access and CHIP Reauthorization...

CMS Releases Initial Report on Risk-Based Bundled Payment Model

by Jacqueline LaPointe

Hospitals and physician group practices (PGPs) participating in the first two cohorts of the Bundled Payments for Care Improvement (BPCI) Advanced have a good chance of reducing episode payments....

Advanced Alternative Payment Model Participation Rose in 2018

by Jacqueline LaPointe

Over 84,200 more eligible clinicians sufficiently participated in one of the Quality Payment Program’s Advanced Alternative Payment Models (APMs) in 2018 compared to the previous year, according...

CMS Says Clinicians to Receive Advanced APM Bonus Payments Soon

by Jacqueline LaPointe

In a fact sheet created on Sept. 27, CMS announced that Advanced Alternative Payment Model (APM) bonus payments for participation in an approved model in 2017 will be going out to qualifying clinicians...

Providers Ask CMS Where Their 2019 Advanced APM Bonus Is

by Jacqueline LaPointe

More than 90,000 clinicians are still waiting on the 2019 Advanced Alternative Payment Model (APM) bonus payment for their participation in 2017 and nine industry groups are demanding payment from...

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