วิวินาวิ

2024 APM Incentive Payment Updates; New APM and APP Resources

Centers for Medicare & Medicaid Services Quality Payment Program
* The Advanced APM Incentive Payment for QPs in the Quality Payment Program is 1.88% for 2024 Performance Period/2026 Payment Year [ #link_1 ]
* Now Available: New Alternative Payment Model (APM) and APM Performance Pathway (APP) Resources [ #link_2 ]

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The Advanced APM Incentive Payment for QPs in the Quality Payment Program is 1.88% for the 2024 Performance Period/2026 Payment Year

In March 2024, Congress extended the Advanced Alternative Payment Model (APM) Incentive Payment for Qualifying APM Participants (QPs) in the CMS Quality Payment Program [ https://qpp.cms.gov/ ] to 1.88% for the 2024 performance period/2026 payment year and established a 0.75% adjustment to the QP conversion factor that will be applied to Medicare payments for covered professional services beginning in 2026. These provisions are intended to continue to encourage eligible clinicians to participate in Advanced APMs.   

Please note, this differs from the 2023 performance period/2025 payment year where eligible clinicians determined to be QPs would receive a 3.5 percent APM Incentive Payment. However, the QP payment amount and patient count thresholds for QPs in Advanced APMs are the same as performance period 2023, remaining frozen at 50% and 35%, respectively, for the 2024 performance period/2026 payment year. 

For additional information regarding the legislative change, please see Section 304 [ https://www.congress.gov/bill/118th-congress/house-bill/4366/text#H7F84C0BA092B43DBB293A14E683FF800 ] of the Consolidated Appropriations Act, 2024 [ https://www.congress.gov/118/bills/hr4366/BILLS-118hr4366enr.pdf ] and Section 1833(z) of the Social Security Act (42 U.S.C. 1395l(z) [ http://uscode.house.gov/quicksearch/get.plx?title=42§ion=1395l ]).   

*What Do I Need to Do in Order to Receive the APM Incentive Payment?*  

Like previous years, if you meet the requirements to be a QP in the 2024 performance period, you will not need to do anything to receive your payment in 2026, unless CMS is unable to verify your Medicare billing information. If you do not receive your payment after initial payments are made, a public notice will be posted with a list of names, which indicates that you will need to verify your Medicare billing information. If you do not verify your Medicare billing information by the date in the notice, then CMS will not be able to issue your APM Incentive Payment.  

*Questions?*  

Please contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292.  

For additional information on APMs, please visit the QPP website [ https://qpp.cms.gov/apms/overview ].

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Now Available: New Alternative Payment Model (APM) and APM Performance Pathway (APP) Resources

CMS recently posted new Quality Payment Program (QPP) resources about Alternative Payment Models [ https://qpp.cms.gov/apms/overview ] (APMs) and the APM Performance Pathway [ https://qpp.cms.gov/mips/apm-performance-pathway ] (APP), a reporting and scoring pathway for Merit-based Incentive Payment System (MIPS) eligible clinicians who participate in MIPS APMs.  

These resources are available on the QPP Resource Library [ https://qpp.cms.gov/resources/resource-library ]:  


* *2024 APP Toolkit (ZIP, 2MB)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3004/2024-APP-Toolkit.zip ] which includes the following resources: 
* *2024 APP Fact Sheet*: Provides an overview of the APP, including who can participate, reporting requirements, the scoring methodology, and frequently asked questions.
* *2024 APP Quick Start Guide*: Shares guidance around data collection and submission requirements for the APP to help MIPS APM participants know what steps to take.
* *2024 APP Scoring Guide*: Provides a general summary about scoring for the APP.

* *2024 APP Quality Requirements (Shared Savings Program ACOs Only) (ZIP, 6MB)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2862/PY2024APPQualityReq_SSPACOs.zip ]: Provides APP quality measure documentation for Shared Savings Program ACOs, including APP quality data submission options, APP quality measure set details, and APP quality measure specifications.
* *2024 APP Quality Requirements (All Participants, Excluding Shared Savings Program ACOs) (ZIP, 3MB)*: [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2861/PY2024APPQualityReq_All.zip ] Includes the APP quality measure documentation for individual, group, and APM Entities. Resources detail APP quality data submission options, APP quality measure set details, and APP quality measure specifications.
* *2024 Learning Resources for QP Status and APM Incentive Payment (ZIP, 3MB)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2925/2024-Learning-Resources-for-QP-Status-and-APM-Incentive-Payment.zip ]*:* Provides information about the amount of Advanced APM incentive payments that were paid to eligible clinicians this year based on their participation in Qualifying APM Participant (QP) performance period 2022.

*Questions?* 

Learn more about APMs and the APP by visiting the APM webpage [ https://qpp.cms.gov/apms/overview ] and the APP webpage [ https://qpp.cms.gov/mips/apm-performance-pathway ].

QPP Footer 2023 [ https://qpp.cms.gov/resources/help-and-support ]


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