ED Coding & Reimbursement Alert - 2018 Issue 10
Weigh the Risks of an Advanced APM with this Checklist
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Article Overview
This article outlines key decision factors for clinicians and practices considering whether to start or join an Advanced APM under the Medicare Quality Payment Program. It focuses on the operational, financial, and data-integration issues that can affect participation, along with broader considerations around entity selection and possible referral relationships. The piece is intended for readers comparing payment program options and assessing readiness for participation.
Why This Topic Matters
Choosing an Advanced APM can affect practice operations, technology needs, financial exposure, and overall Quality Payment Program strategy. Understanding the main considerations in advance helps practices evaluate whether participation aligns with their goals and resources.
Article Sections
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Overview
Introduces the decision context for clinicians evaluating participation in an Advanced APM under Medicare payment programs.
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Key factors to consider
Summarizes the main operational, technical, and financial considerations involved in evaluating participation in an Advanced APM.
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Bonus consideration
Addresses an additional strategic issue related to participation status and broader program planning.
What You Will Learn
- The main considerations involved in evaluating an Advanced APM opportunity
- How participation can affect workflow, technology, and financial planning
- Why entity selection and regional market context may matter
- How broader Quality Payment Program strategy can factor into the decision
Who Should Read This
- Physicians and other Part B clinicians
- Practice administrators
- Medical billing and coding professionals
- Revenue cycle and compliance staff
- Healthcare executives evaluating payment models
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