June 07, 2017
The Centers for Medicare and Medicaid Services (CMS) has indicated that a programmatic goal is to provide clear communication around clinicians’ Advanced Alternative Payment Model Qualifying Participant (QP) status. In support of this goal, CMS is supplying 2017 Advanced APM eligible clinicians with a predictive QP status based on historical claims data. By looking at historical Part B claims data, CMS predicts that nearly 100% of eligible clinicians in Advanced APMs with data currently available will be QPs in performance year 2017.
This analysis is a prediction of your likely QP status for the 2017 performance year based on historical claims data. For this analysis, CMS used administrative claims with dates of service between 1/1/16 and 8/31/16 that were processed between 1/1/16 and 11/30/16. Actual QP determinations will use claims data from the relevant performance year.
For the first two performance years of the Quality Payment Program (2017 and 2018), a QP must receive at least 25% of their total Medicare Part B payments or see at least 20% of their total Medicare patients through the APM to receive the 5% bonus payment.
More information on this analysis is available here.