tci Medicare Compliance & Reimbursement - 2018 Issue 10
Reimbursement: Follow This Expert Advice on Advanced APMs
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Article Overview
This article explains the broader reimbursement landscape around the Quality Payment Program, with emphasis on how Advanced APMs compare with MIPS and MIPS APMs. It discusses why some clinicians and specialties may find one track more practical than another, the general financial and operational considerations involved, and the role of industry organizations and CMS guidance in evaluating participation options.
Why This Topic Matters
Providers and coding/reimbursement professionals need a clear view of how APM participation affects payment strategy, reporting burden, and practice fit. This is especially important for specialty practices evaluating whether an Advanced APM aligns with their clinical and operational realities.
What You Will Learn
- How Advanced APMs fit within the Quality Payment Program
- How Advanced APMs compare with MIPS and MIPS APMs at a high level
- Why participation choices may differ by specialty and practice type
- What general financial and operational factors influence APM decisions
- Which organizations and CMS resources are referenced in the discussion
Who Should Read This
- Physicians
- Eligible clinicians
- Practice managers
- Reimbursement specialists
- Coding professionals
- Specialty practices
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