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All About APMs: What Will It Take for Physicians to Earn the APM Bonus Under MACRA?

June 21, 2016Client Advisory

On May 9, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule addressing the implementation of physician payment reforms included in the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”). The proposed rule outlines the CMS framework for the Merit-Based Incentive Payment System (“MIPS”) and physician participation in Advanced Alternative Payment Models (“Advanced APMs”), two programs that intend to shift Medicare physician payments toward payments for value over volume.

In this third Client Alert in a series prepared by Epstein Becker Green and EBG Advisors about the MACRA proposed rule, we provide more details about how CMS proposes to define “Advanced APMs,” including the financial risks that physicians and other clinicians are required to take on through participation in an Advanced APM to be eligible for a 5 percent bonus payment starting in 2019. All stakeholders are encouraged to provide CMS with feedback on the proposed rule to help shape how these payment reforms are implemented. Comments are due no later than 5 p.m. (EDT) on June 27, 2016.

Download the full Alert in PDF format.

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