6. How do I participate in an Advanced APM? Physicians would participate in an Advanced APM through an APM Entity. There is flexibility in how an APM Entity could be formed. It could be comprised of: A solo practitioner A group practice of physicians and other eligible clinicians with a single tax identification number (TIN) A combination of physicians and other eligible clinicians from different practices and multiple TINs Regardless of its makeup, each APM Entity would have its own TIN for participating in a specific Advanced APM. Participation in an Advanced APM is determined at the APM Entity level. Physicians and other eligible clinicians identified on the APM Entity’s Participation List must collectively meet the QP/PQ thresholds as an APM Entity group for each individual physician to receive credit for participation in an Advanced APM. Additional details on becoming a QP/PQ can be found at here. Use the CMS APM Lookup tool to determine your status CMS uses the following criteria to determine which existing APMs qualify for the Advanced APM pathway under the QPP that would allow physicians participating through an APM Entity to be eligible for the 5% incentive payment. Advanced APMs under the QPP generally must: Be a certain Center for Medicare & Medicaid Innovation Model (CMMI), Shared Savings Program track, or certain federal demonstration program; Require participants to use certified electronic health record technology (CEHRT); Base payments for services on quality measures comparable to those in MIPS; and Is either a Medical Home Model expanded under CMMI or requires the APM Entity to bear more than nominal financial risk for losses. Note: each APM will have its own participation requirements that specify the level of CEHRT use, risk arrangement under that APM, shared savings/losses under that model, etc. The QPP does not affect or change these arrangements. To learn about specific APM participation requirements, please see the overview resources available on PAI’s Advanced APM Pathway page as well as the CMS Innovation Center website Pages Advanced APMs1. I practice in an ACO/Patient Centered Medical Home (PCMH) part-time but also practice in a different location that is not an ACO/PCMH, am I in an Advanced APM, MIPS or a MIPS APM?2. Is it too late to be in an advanced APM for 2020? 2021?3. If I am in an alternative payment model (such as an ACO), do I still have to participate in MIPS?4. How does CPC+ work with MACRA?5. What Advanced APMs are available in 2020?6. How do I participate in an Advanced APM?7. What is an Other Payer Advanced APM?8. What is the All-Payer Count?9. How is my QP/PQ determination made under the Medicare Count Methods and/or All-Payer Count Methods? Comments are closed.