{"id":4377,"date":"2018-03-14T11:10:57","date_gmt":"2018-03-14T17:10:57","guid":{"rendered":"https:\/\/osteopathic.org\/?page_id=4377"},"modified":"2025-05-15T17:01:16","modified_gmt":"2025-05-15T22:01:16","slug":"apm-guide","status":"publish","type":"page","link":"https:\/\/osteopathic.org\/practicing-medicine\/quality-payment-program\/apm-guide\/","title":{"rendered":"APM Guide"},"content":{"rendered":"<p>The second track of the <a href=\"https:\/\/osteopathic.org\/practicing-medicine\/business-of-medicine\/quality-payment-program\/\">CMS Quality Payment Program<\/a> is advanced Alternative Payment Models (APMs). Advanced APMs provide extra incentives for providing high-quality, cost-effective care for a specific pool of patients by requiring practices to take on two-sided financial risk.<\/p>\n<p>For 2018, if you participate in an advanced APM, you can earn up to a 5% bonus, which will be awarded in 2020. To earn the bonus, you must earn 25% of your Medicare Part B revenue through the advanced APM or treat 20% of your Medicare patients through the advanced APM. If you&#8217;re at risk of not meeting those benchmarks, most advanced APMs allow you to submit MIPS data for 2018 so you can avoid getting a penalty in 2020.<\/p>\n<p>If you participated in an APM for the 2017 performance year, you can use <a title=\"Link to CMS\" href=\"https:\/\/data.cms.gov\/qplookup\" target=\"_blank\" rel=\"noopener noreferrer\">this CMS tool<\/a> to see whether you achieved qualified participant status.<\/p>\n<h3>2018 APM options<\/h3>\n<p>For 2018, the CMS recognizes<a href=\"https:\/\/innovation.cms.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\"> nine APM models<\/a>. To join one, you&#8217;ll need to choose one that fits your practice and check to see whether it&#8217;s accepting applications.<\/p>\n<ul>\n<li><a href=\"https:\/\/innovation.cms.gov\/initiatives\/bundled-payments\/\" target=\"_blank\" rel=\"noopener noreferrer\">Bundled Payments for Care Improvement Advanced Model (BPCI Adanced)<\/a><\/li>\n<li><a href=\"https:\/\/innovation.cms.gov\/initiatives\/comprehensive-esrd-care\/\" target=\"_blank\" rel=\"noopener noreferrer\">Comprehensive ESRD Care &#8211; Two-sided risk<\/a><\/li>\n<li><a href=\"https:\/\/innovation.cms.gov\/initiatives\/comprehensive-primary-care-plus\">Comprehensive Primary Care Plus (CPC+)<\/a><\/li>\n<li><a href=\"https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/sharedsavingsprogram\/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">Medicare Accountable Accountable Care Organization (ACO) Track 1+ Model<\/a><\/li>\n<li><a href=\"https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/sharedsavingsprogram\/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">Medicare Shared Savings Track 2\u00a0<\/a><\/li>\n<li><a href=\"https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/sharedsavingsprogram\/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">Medicare Shared Savings Track 3<\/a><\/li>\n<li><a href=\"https:\/\/innovation.cms.gov\/initiatives\/Next-Generation-ACO-Model\/\" target=\"_blank\" rel=\"noopener noreferrer\">Next Generation ACO Model (NextGen)<\/a><\/li>\n<li><a href=\"https:\/\/innovation.cms.gov\/initiatives\/oncology-care\/\" target=\"_blank\" rel=\"noopener noreferrer\">Oncology Care Model two-sided risk arrangement (OCM)<\/a><\/li>\n<li><a href=\"https:\/\/innovation.cms.gov\/initiatives\/cjr\" target=\"_blank\" rel=\"noopener noreferrer\">Comprehensive care for joint replacement payment model (Track 1 &#8211; CEHRT)<\/a><\/li>\n<\/ul>\n<h3 class=\"ms-rteElement-H4\"><strong>APM benchmarks<\/strong><\/h3>\n<p class=\"ms-rteElement-P\">APMs require two-sided financial risk, which means that while your practice could potentially lose money, you also stand to gain revenue. Here&#8217;s the setup:<\/p>\n<ul>\n<li>2018-2020:\u00a0 To earn the 5% bonus, 25% of all your Medicare revenue must be in advanced APMs, or you must have seen 20% of your Medicare patients through an advanced APM.<\/li>\n<li>2021-2022: 50% of all your Medicare revenue must be in APMs, or 25% of all your Medicare revenue and 50% of your revenue from all payers must be in advanced APMs.<\/li>\n<li>2023 and on: 75% of all your Medicare revenue must be in advanced APMs, or 25% of all your Medicare revenue and 75% of your revenue from all payers must be in APMs.<\/li>\n<\/ul>\n<h3 class=\"ms-rteElement-H4\">Leaving an APM<\/h3>\n<p>If your practice leaves an advanced APM in 2018, be sure you&#8217;ve seen enough patients or earned enough advanced APM revenue, as described above, to earn the 5% bonus. If you haven&#8217;t met the benchmarks above, you&#8217;ll need to submit MIPS data so as not to get a penalty in 2020. <a href=\"https:\/\/qpp.cms.gov\/apms\/overview\" target=\"_blank\" rel=\"noopener noreferrer\">Learn more<\/a>.<\/p>\n<h3>Getting help<\/h3>\n<p>AOA members can <a href=\"https:\/\/osteopathic.org\/about\/contact-us\/\">contact the AOA<\/a> for free, personalized assistance with APMs and the Quality Payment Program. Physicians can also contact CMS at (866) 288-8292 or <a href=\"mailto:qpp@cms.hhs.gov\">qpp@cms.hhs.gov<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The second track of the CMS Quality Payment Program is advanced Alternative Payment Models (APMs). Advanced APMs provide extra incentives for providing high-quality, cost-effective care for a specific pool of patients by requiring practices to take on two-sided financial risk. For 2018, if you participate in an advanced APM, you can earn up to a &hellip; <a href=\"https:\/\/osteopathic.org\/practicing-medicine\/quality-payment-program\/apm-guide\/\" class=\"readmore\">Read More<\/a><\/p>\n","protected":false},"author":4,"featured_media":6313,"parent":2676,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v21.4 (Yoast SEO v21.4) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>APM Guide - American Osteopathic Association<\/title>\n<meta name=\"description\" content=\"A guide to APMs, a payment model that provides incentives for high-quality, cost-effective care by requiring practices to take on two-sided financial risk.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/osteopathic.org\/practicing-medicine\/quality-payment-program\/apm-guide\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"APM Guide\" \/>\n<meta property=\"og:description\" content=\"A guide to APMs, a payment model that provides incentives for high-quality, cost-effective care by requiring practices to take on two-sided financial risk.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/osteopathic.org\/practicing-medicine\/quality-payment-program\/apm-guide\/\" \/>\n<meta property=\"og:site_name\" content=\"American Osteopathic Association\" \/>\n<meta property=\"article:modified_time\" content=\"2025-05-15T22:01:16+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/osteopathic.org\/wp-content\/uploads\/2018\/05\/apm.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1400\" \/>\n\t<meta property=\"og:image:height\" content=\"325\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/osteopathic.org\/practicing-medicine\/quality-payment-program\/apm-guide\/\",\"url\":\"https:\/\/osteopathic.org\/practicing-medicine\/quality-payment-program\/apm-guide\/\",\"name\":\"APM Guide - 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