CMS has finalized the Alternative Payment Model (APM) Performance Pathway, or the APP— a new reporting and scoring pathway for Merit-based Incentive Payment System (MIPS) eligible clinicians who participate in MIPS APMs. The APP will be complementary to the MIPS Value Pathways (MVPs) and include a single, pre-determined measure set that MIPS APM participants may report on at the individual, group, and/or APM Entity levels beginning with the 2021 performance year.

What are the benefits of reporting through the APP?

The APP is designed to provide reliable and consistent MIPS reporting requirements to reduce reporting burden and encourage continued APM participation.

Who is eligible to report through the APP?

Any MIPS eligible clinician who is on a participation list or affiliated practitioner list of any APM Entity participating in a MIPS APM on 1 of the 2021 snapshot dates (March 31, June 30, August 31, December 31, 2021) may report via the APP.

Is anyone required to report through the APP?

The APP is required for all Medicare Shared Savings Program accountable care organizations (ACOs), though MIPS eligible clinicians participating in those ACOs have the option to report through the APP outside of the ACO or participate in MIPS outside of the APP at the individual or group level.

What are the performance category weights and reporting requirements for the APP in 2021?

Quality

  • 50% of the MIPS Final Score
  • Report on the 3 MIPS eCQM or CQM quality measures and the CAHPS for MIPS Survey measure in the APP measure set
  • CMS calculates 2 administrative claims measures in the APP measure set

(Note: For the 2021 performance year only,  ACOs have the option to report the 10 CMS Web Interface measures in place of the 3 eCQM/MIPS CQM measures (001, 134, 236).)

Cost

  • 0% of the MIPS Final Score
  • No requirements

Improvement Activities

  • 20% of the MIPS Final Score
  • Automatically assigned based on the improvement activity requirements of the MIPS APM in which the MIPS eligible clinician participates*

Promoting Interoperability

  • 30% of the MIPS Final Score
  • Same reporting as traditional MIPS

*All MIPS APM participants who report through the APP in 2021 will automatically receive 100% for the Improvement Activities performance category score.

Where can I find more information?

Please check out the following resources to learn more about the APP:

Questions?

Contact the Quality Payment Program at 1-866-288-8292 or by e-mail at: QPP@cms.hhs.gov. To receive assistance more quickly, please consider calling during non-peak hours—before 10:00 a.m. and after 2:00 p.m. ET.

Customers who are hearing impaired can dial 711 to be connected to a TRS Communications Assistant.

About Author

Healthcentric Advisors
As the New England Quality Payment Program Support Center, Healthcentric Advisors assists New England-based physician and other eligible clinical practices to prepare for and participate in the new Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).