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Changes in Advanced APMs explained

Jul 14, 2025

CMS is emphasizing a shift in health care delivery, aiming for all traditional Medicare beneficiaries to be in accountable care models by 2030.

  • This aligns with efforts to transform how health care is managed and delivered nationwide.

What's new: In the latest proposed rule, CMS outlines adjustments in beneficiary attribution for QP status determinations.

  • These changes are designed to encourage participation in Advanced APMs and enable more specialists to participate.

Why it matters: Clinicians in Advanced APMs achieving QP or Partial QP status is exempt from MIPS reporting and payment adjustments.

  • This exemption provides significant administrative relief and financial incentives for eligible participants.

Details: Congress has also extended the APM Incentive Payment amount to 1.88% for the 2026 payment year.

  • This reflects ongoing legislative support to encourage participation in these models.

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