Knowledge Expansion

Quality Reimbursement: CMS’s Move Away From Traditional Fee-For-Service Reimbursement and the Impact on Physician Practices

Fellowship Paper

Reimbursement

Steven B. Smith MBA, FACMPE
The Centers for Medicare and Medicaid Services (CMS) has introduced a number of Alternative Payment Models (APMs) in the recent past in an effort to move away from traditional fee-for-service reimbursement methodology.  These models take into consideration a number of variables including resource utilization, quality of care, practice improvement, and the expansion of offered services when providing reimbursement to providers.  This paper will examine three such APMs introduced by CMS since 2013: Comprehensive Care for Joint Replacement (CJR), Comprehensive Primary Care Plus (CPC+), and the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA).  Each APM will be analyzed and the reader will be provided with an overview of the model, requirements for participation, and the keys to success under the specific model.
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About the Author

Steven B. Smith MBA, FACMPE
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