CMS expects to reopen CPC+ and Next Generation ACO applications to expand Advanced APM participation


When CMS published the final Quality Payment Program rule earlier this month, it indicated that there would be expanded opportunities for clinicians and groups to participate in Advanced Alternative Payment Models (APMs). Providers who participate in these APMs at sufficient levels will be eligible to earn a five percent incentive payment each year beginning in 2019.

Today, CMS announced a concrete step toward expanding Advanced APM participation: it expects to reopen applications for new practices and payers in the Comprehensive Primary Care Plus (CPC+) model and new participants in the Next Generation Accountable Care Organization (ACO) model for the 2018 performance year.

Both CPC+ and the Next Generation ACO model qualify as Advanced APMs in the 2017 performance year, but neither is currently open to new participant applications.

CPC+ is a national advanced primary care medical home model that aims to strengthen primary care through a regionally based multi-payer payment reform and care delivery transformation. It is a five-year model that will operate in 14 regions beginning on January 1, 2017.

The Next Generation ACO model is an initiative for ACOs that are experienced in coordinating care for populations of patients, which allows groups to assume higher levels of financial risk and reward than are available under the current Pioneer Model and Medicare Shared Savings Program (MSSP).

Other Advanced APMs to watch

Beyond CPC+ and the Next Generation ACO model, CMS has announced that the following APMs will be considered Advanced APMs in 2017 and as candidates for Advanced APMs in 2018.

Year Advanced APMs
  • Comprehensive ESRD Care Model (Large Dialysis Organization (LDO) arrangement)
  • Comprehensive ESRD Care Model (non-LDO arrangement)
  • CPC+
  • Medicare Shared Savings Program ACOs—Track 2
  • Medicare Shared Savings Program ACOs—Track 3
  • Next Generation ACO Model
  • Oncology Care Model (two-sided risk arrangement)
2018 (Anticipated)
  • ACO Track 1+
  • New voluntary bundled payment model
  • Comprehensive Care for Joint Replacement Payment Model (Certified Electronic Health Record Technology (CEHRT) track)
  • Advancing Care Coordination through Episode Payment Models Track 1 (CEHRT track)

Keep an eye out for more information on application timelines to apply for participation in these models for the 2018 performance year. CMS estimates that 25 percent of clinicians in the Quality Payment Program will earn incentive payments by being a part of Advanced APMs by the 2018 performance period. Stay informed of key dates and deadlines as they approach by subscribing to our newsletter.

Further reading:
How using the MIPS 90-day reporting period will increase your 2017 Composite Score
Avoiding a penalty in 2018 MIPS: the nuts and bolts

Email Alerts

Stay informed with Able Health email alerts

Be the first to know about key PQRS and MACRA information, deadlines, and expert analysis