Alternative Payment Models (APMs)

March 20, 2018

What are Alternative Payment Models?

APM (Alternative Payment Models)- An Alternative Payment Model (APM) is a payment approach that gives added incentive payments to provide high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population *

How Do APMs Impact Physicians?

The implementation of MACRA and other alternative payment models by CMS signals the transition from fee-for-service reimbursement models to value-based care. By 2018, CMS aims to have 90% of Medicare payments tied to quality or value measures (Source: 2015 CMS Fact Sheet, Better Care. Smarter Spending. Healthier People: Paying Providers for Value, Not Volume; https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-3.html). Participation in APMs could give physicians the ability to opt out of MACRA and possibly qualify for a 5% annual bonus.

How Does Integra Connect Help Providers Transition to Alternative Payment Models?

Integra Connect works with specialty practices to gather real-world quality and cost data through a variety of tactics, including advisory boards and direct access, then develops economics models (APMs) to facilitate performance improvements in alignment with MACRA objectives. Once the APM is submitted and approved – either by CMMI or commercial payers – Integra Connect informs physicians of the new model to initiate their transition. Integra Connect helps providers confidently succeed under newly developed APMs by providing best practices and visibility into performance via quality measure dashboards.

Request More Information about Integra Connect’s APM Development Program.

Source: https://qpp.cms.gov/apms/overview