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MACRA, MIPS, and APMs — Are You Ready?: Page 3 of 3

MACRA, MIPS, and APMs — Are You Ready?: Page 3 of 3

2. Lump-sum incentive payments

One of the advantages to participating in an APM is that qualifying participants will not be subject to MIPS adjustments and will receive a lump-sum incentive payment equal to 5 percent of the prior year's estimated aggregate expenditures under the fee schedule. The 5 percent incentive payment is available from 2019 to 2024, but beginning in 2026, the fee schedule growth rate will be higher for qualifying APM participants than for other practitioners. Should you participate in a qualified APM at levels below the MACRA thresholds, don't worry; it allows physicians to improve their MIPS scores.


Whether you are anticipating participating in an APM or a MIPS model, all providers should review and comment on the proposed Quality Measure Development Plan, and check out the related informational resources provided by CMS. In addition, the American Medical Association has an excellent resource available that provides more detailed information on both programs under MACRA, along with a preparation checklist.


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