CMS opens more alternative payment models for MACRA bonus

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CMS is offering more paths for practices and payers to earn incentive payments under the Medicare Access and CHIP Reauthorization Act (MACRA).

The agency announced more models which will qualify for the 5 percent MACRA bonus under the new Advanced Alternative Payment Models (APMs) track for the next two years. In 2017, clinicians can earn the bonus with “sufficient participation” in one of the following:

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

For 2018, CMS said it will allow new practices and payer to apply for CPC+ and new participants in the Next Generation ACO model. Clinicians could also qualify for the bonus by participating in these additional models:

  • ACO Track 1+
  • 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)

CMS said including these models is part of the agency’s mission to include “many paths” in the new MACRA payment systems, including for accountable care organizations (ACOs).

“With these new opportunities, CMS expects that by the 2018 performance period, 25 percent of clinicians in the Quality Payment Program will earn incentive payments by being a part of these advanced models,” CMS Deputy Administrator Patrick Conway, MD, said in a statement. “Thanks to MACRA and the Innovation Center, we’re striving to see more Medicare patients benefit from better care when they visit their doctor for a knee replacement, receive cancer treatment, or have a coordinated care team manage their complex conditions.”

The additional models don’t include MSSP Track 1. Without being eligible for the 5 percent MACRA bonus, 56 percent of ACOs participating in the program indicated they would MSSP Track 1 in a survey conducted after the proposed MACRA rule came out. The final rule left out MSSP Track 1, despite calls for its inclusion from the National Association of ACOs.

CMS did leave the door open slightly that the list of eligible models will “continue to change and grow as more models are proposed and developed in partnership with the clinician community and the Physician-Focused Payment Model Technical Advisory Committee.”