MACRA QPP Center

Physicians Advocacy Institute

Advanced APM Pathway

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Advanced APM Resource Navigation Tool

This interactive tool will help you navigate what resources and support organizations are available and can provide additional information for those already participating in an Advanced APM and those interested in participating in an Advanced APM.

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Advanced APM Overview

Advanced APMs are one of two pathways physicians can choose under the Quality Payment Program (QPP. Under the Advanced APM Pathway, physicians may be eligible to receive a 5% incentive payment. This resource provides an overview of the relevant QPP rules for Advanced APM participation thresholds and requirements.

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Next Generation Accountable Care Organization (ACO) Model

The Next Gen ACO model allows ACOs to assume higher levels of financial risk and reward than under the traditional Medicare Shared Savings Program (MSSP) Tracks 1, 1+, 2, and 3 ACOs, and allows for first dollar shared savings but also first dollar shared losses. This resource focuses on the variables and rules impacting performance under the Next Generation ACO Model.

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Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO) Models

The Centers for Medicare and Medicaid Services (CMS) established the MSSP under the authority of the Affordable Care Act (ACA). This resource focuses on the variables and rules impacting performance under the MSSP ACO Tracks 1, 1+, 2, and 3.

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Comprehensive Primary Care Plus (CPC+) Model

This resource focuses on the variables and rules impacting performance under the CPC+ model. While CPC+ is a two-part model and engages with payers outside of Medicare, the focus of this overview is on the Medicare component of the model for the QPP Advanced APM pathway.

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Oncology Care Model Overview

The OCM is a 5-year model focused on increasing the coordination of oncology care through financial and performance accountability for chemotherapy episodes of care. This resource focuses on the variables and rules impacting performance under the OCM.

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MIPS APM Overview

This resource provides an overview of MIPS APMs, which are a hybrid between the MIPS pathway and the Advanced APM pathway and have different reporting requirements and scoring than if physicians were participating in exclusively one pathway.

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Side-by-Side Comparison of ACOs

This resource provides a side-by-side comparison of the requirements, risk arrangements, and other APM specifications for Medicare Shared Savings Program (MSSP) Track 1, 1+, 2, 3 ACOs, and Next Generation ACOs.

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APM Building Blocks

This resource highlights the types of variables and rules to be attuned to for specific Advanced APMs. Specifically, this resource will provide an overview of the interactions between core care management techniques, data insights, and what it means to “take risk.”

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MIPS APM Scoring Resource

This resource details the scoring standard used for MIPS APMs, a hybrid between the MIPS pathway and the Advanced Alternative Payment Model (APM) pathway.

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