Advanced APM Update Proposed Rule and Beyond

Why This Topic Matters

The piece helps readers understand how proposed Advanced APM changes and meeting announcements may affect participation, qualifying participant status, quality measurement burden, and the direction of value-based care in nephrology.

Article Sections

1. Qualifying Participant

   Introduces recent updates related to participant qualification status in an Advanced APM context. The section frames how status affects broader program participation and payment model treatment.

2. NPRM

   Summarizes the proposed rule’s main areas of attention for Advanced APMs. Topics include eligibility-related requirements, quality-related criteria, financial risk, and alignment with other payer models.

3. CEHRT

   Discusses the proposed change tied to certified electronic health record technology use among eligible clinicians in the model. The section presents the policy topic in the context of existing program requirements.

4. Quality

   Covers the proposed clarification related to quality measures within the model. The section also places the discussion in the broader context of meeting observations and program expectations.

5. Downside risk

   Addresses the proposed approach to financial risk standards for Advanced APMs. The section explains that the article is focused on the policy framework governing risk exposure over future performance years.

6. Other payer Advanced APMs

   Reviews the concept of combining participation across Medicare and non-Medicare payment arrangements. The section explains how CMS is aligning this pathway with the Medicare-only framework.

7. Face-to-face

   Summarizes highlights from a nephrology-focused face-to-face meeting in Washington, DC. The section discusses program participation, organizational involvement, beneficiary alignment, and upcoming quality simplification.

8. Adam Boehler

   Describes remarks from the new CMMI director and the article’s take on leadership priorities. The section focuses on value-based care direction and anticipated attention to renal care models.