Summary
This document is an issue brief regarding Alternative Payment Models (APMs) in the context of the Medicare Access & CHIP Reauthorization Act (MACRA). It outlines the changes brought by MACRA, which introduced two participation options: the Merit-based Incentive Payment System (MIPS) and APMs. The brief explains that APMs require participants to be accountable for patient costs and outcomes, and details the financial incentives provided for participation, including a bonus that was extended through 2023 but reduced from 5% to 3.5%. It also discusses the criteria for qualifying participants and the challenges posed by increased thresholds for the 2024 performance year. Furthermore, the brief highlights the role of the Center for Medicare & Medicaid Innovation (CMMI) and the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in developing and testing APMs. It emphasizes the need for more APM options to facilitate value-based healthcare reform and outlines advocacy priorities for supporting the development of new physician-led APMs.
