Alternative Payment Models (APMs)

Updated: 05/22/2024 | Views: 1620

An Alternative Payment Model (APM) is an approach to payment, developed in partnership with clinician communities, providing incentives to clinicians to provide high-quality and cost-effective care. Clinicians must apply or be invited to participate in an APM. Each APM Type has unique requirements, please contact your APM program coordinator to discuss program and technology requirements.

Examples of the approved MIPS-APMs and Advanced APMs include:

• Bundled Payments for Care Improvement Advanced Model (BPCI Advanced)
• Kidney Care Choices: Comprehensive Kidney Care Contracting (CKCC)
• Oncology Care Model (OCM) - Two-Sided Risk, One-Sided Risk
• Primary Care First (PCF) Model

For a full list of Approved APMS visit Quality Payment Program.

Clinicians can use the APM Lookup Tool to check their Qualifying APM Participant(QP) status.

Important facts to know about APMs:

• APMs are Medicare Incentive Programs.
• They are usually managed by local medical entities such as hospitals, medical groups, or Independent Physician Associations (IPAs).
• Participating providers might also be required to participate in the MIPS track.
• APM administrators assign quality measures to participating providers.