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- New updates to advanced alternative payment models (APMs)
For the Advanced APM track, if an eligible clinician participates in an Advanced APM and achieves Qualifying APM Participant (QP) or Partial QP status, they are excluded from the MIPS reporting requirements and payment adjustment.
The impact: According to CMS, the agency continues to focus on transforming health care delivery towards the goal of having all traditional Medicare beneficiaries in an accountable care relationship with their health care provider by 2030.
- To achieve this, the CMS has finalized changes to how QP status is determined to include both individual and group determinations.
Also, the CMS has also expanded the definition of “attribution-eligible” Medicare beneficiaries to remove the necessity that a participating clinician bill an evaluation and management code for a beneficiary to be attributed to an APM.
Taken together, the CAP believes these proposals could lead to an increase in APM participation for pathologists, although the impact remains to be seen in coming years.