CMS to Test Medicare Advantage as Alternative Payment Model Under MACRA

The Centers for Medicare and Medicaid Services (CMS) wants to launch an experiment that allows doctors in Medicare Advantage plans to qualify as participating in an alternative pay model. To comply with MACRA (Medicare Access and CHIP Reauthorization Act), clinicians have two tracks to choose from: Merit-based Incentive Payment System (MIPS), which requires clinicians to report and meet quality goals, and advanced alternative payment models (APM), which require clinicians to take on financial risk as part of efforts to improve care and lower costs. If goals are met under an APM they’re eligible for bonuses. Clinicians in Medicare Advantage plans have urged CMS to consider those plans as APMs since some are offering risk-based contracts. The White House’s Office of Management and Budget must approve any experiment.   (Virgil Dickson, Modern Healthcare)


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