CMS Announces Additional Opportunities for Clinicians under the Quality Payment Program

January 6, 2017
Policy Snapshot

On December 15, the Centers for Medicare & Medicaid Services (CMS) announced more new opportunities for clinicians to join Advanced Alternative Payment Models (APMs) to improve care and earn additional incentive payments under the Quality Payment Program, which implements the Medicare Access and CHIP Reauthorization Act of 2015. Beginning in January and February 2017, CMS will open applications for new rounds of two CMS Innovation Center models for the 2018 performance year – 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. With these new opportunities, CMS expects that by the 2018 performance period, 25 percent of clinicians in the Quality Payment Program would be a part of these advanced models and may be eligible to earn incentive payments.

For the 2017 performance year, under the Quality Payment Program, clinicians may earn a 5 percent incentive payment through sufficient participation in the following Advanced APMs:

  • Comprehensive End-Stage Renal Disease (ESRD) Care Model (Large Dialysis Organization (LDO) arrangement)
  • Comprehensive ESRD Care Model (non-LDO two-sided risk arrangement)
  • CPC+
  • Medicare Shared Savings Program - Track 2
  • Medicare Shared Savings Program - Track 3
  • Next Generation ACO Model 
  • Oncology Care Model (two-sided risk arrangement) 

In 2018, CMS anticipates that clinicians may also earn the incentive payment through sufficient participation in the following new and existing models:

  • Medicare ACO Track 1+ Model
  • 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)

To learn more about QPP check out the Society’s webinar “Overview of MACRA for PALTC Practitioners.” Free for Society members.