CHA News Article

Qualifying APM Participant Status Released

The Centers for Medicare & Medicaid Services (CMS) has released its predicted alternative payment model (APM) qualifying participant (QP) status for 2017 advanced APMs.

CMS used administrative claims with dates of service between Jan. 1 and Aug. 31, 2016, that were processed between Jan. 1 and Nov. 30, 2016, to estimate QP and partial QP status. Its analysis, based on historical Part B claims data, predicted that nearly 100 percent of eligible clinicians in advanced APMs for whom data is currently available will be QPs in performance year 2017. CMS also predicted whether clinicians are likely to be eligible for the 5 percent APM incentive payment in the 2019 payment year.

CMS’ predictions are based on participation in at least one of the following Advanced APMs in performance year 2017:

  • Comprehensive End Stage Renal Disease Care – Two-Sided Risk
  • Comprehensive Primary Care Plus
  • Next Generation Accountable Care Organization Model
  • Medicare Shared Savings Program – Track 2
  • Medicare Shared Savings Program – Track 3

Predictions were not made for participants in the Comprehensive Care for Joint Replacement Model—CEHRT Track or Oncology Care Model—Two-Sided Risk Arrangement. More information is available in the attached fact sheet.