More clinicians able to join Next Generation ACOs, CPC+ for 2018

For the 2018 performance period of the Quality Payment Program (QPP), a program designed to reform Medicare payments to physicians to improve the quality of care provided, physicians will have additional opportunities to join two Advanced Alternative Payment Models (Advanced APMs). The Next Generation Accountable Care Organization (ACO) model and the Comprehensive Primary Care Plus (CPC+) model will accept new applications for participation early in 2017. Once new applicants are accepted, CMS expects that 25 percent of QPP participants will be part of Advanced APMs for performance year 2018 and eligible to receive incentive payments from Medicare.

The QPP is part of CMS’ implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (P.L. 114-10), which builds on measures created by the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148). It consists of two tracks for eligible professional participation: Advanced APMs and the Merit-based Incentive Payment System (MIPS). To participate as an Advanced APM, the eligible professional must be part of certain payment models, including the Next Generation ACO and CPC+ models, both of which were created by the CMS Innovation Center, which was established under section 3021 of the ACA.

The announcement that both models will open for applications in early 2017 follows promises made by CMS two months ago (see New alternative payment models announced by CMS, October 26, 2016). As part of its announcement, CMS released a Fact Sheet on the CPC+ Payer and Practice Solicitation. The American Medical Association (AMA) commended the expansion, saying that, because of Advanced APMs, “physicians will have more time with patients and more flexible payments to support care coordination and improvements in access and quality.”