decisionhealth Newsletters, Part B News - 2016 Issue 8 (August)
More bundled payment models could qualify as MACRA advanced APMs
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Article Overview
This article covers a CMS proposed rule that would expand the advanced APM definition within the MACRA quality payment program to include certain mandatory bundled payment models. It is relevant to clinicians, hospitals, and billing/coding professionals who follow Medicare payment policy, alternative payment models, and CMS rulemaking. The discussion also touches on model scope changes, implementation timing, and the general criteria CMS proposes for model qualification.
Why This Topic Matters
The proposed policy could affect whether participants in certain bundled payment arrangements are eligible for MACRA-related incentives and how practices track participation in CMS payment models. It is important for organizations monitoring Medicare reimbursement, value-based payment design, and reporting timelines.
Article Sections
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Proposed expansion of advanced APM eligibility
Summarizes the CMS proposal to broaden advanced APM treatment for certain mandatory bundled payment models under MACRA. It frames the article around Medicare payment policy and alternative payment model participation.
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Model criteria and related program changes
Describes the general requirements CMS says participating providers would need to meet and notes related changes to existing and proposed bundled payment programs. It also covers the timing of implementation and phase-in mentioned in the article.
What You Will Learn
- How the article situates CMS proposed payment policy changes within MACRA
- What types of bundled payment models are discussed at a high level
- Which general eligibility themes CMS ties to advanced APM qualification
- How the article connects the proposal to implementation timing and program expansion
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Practice managers
- Hospital administrators
- Compliance staff
- Healthcare policy analysts
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