Below are a number of resources to help member hospitals understand the regulatory framework as they move toward development and implementation of one or more alternative payment models (APMs). The information includes:
- General and program-specific resources for mandatory models such as the Comprehensive Care for Joint Replacement (CJR) Model
- Voluntary models such as the Medicare Shared Savings Program (MSSP) and the Bundled Payments for Care Improvement Initiative (BPCI)
- Models that qualify as advanced alternative payment models for physician payment incentives under the Medicare Access and CHIP Reauthorization Act of 2015
In addition, we have provided a list of helpful Centers for Medicare & Medicaid Services (CMS) website links under each of the tabs below for additional information.
As CMS continues to support new alternative payment and delivery models to reward better, more efficient, coordinated patient care, CHA encourages members to follow this page. It will be updated regularly with general and program-specific resources as they become available.
Available Resources
General APM
CHA Alternative Payment Model Guiding Principles
CJR
CJR Model 3 Year Extension and Changes to Episode Definition and Pricing Proposed Rule
- Proposed Rule Summary
Final Rule – Extreme and Uncontrollable Circumstances Policy for the CJR Model
- List of Participating Hospitals and Status
- OIG and CMS Joint Statement of Waivers (effective Jan. 1, 2018)
- MLN Matters Article on SNF Three-Day Rule Waiver (Jan. 2017)
- CJR Model Frequently Asked Questions (updated March 8, 2018)
BPCI
CMS Announces Bundled Payments for Care Improvement Advanced Model
- Overview of Changes to the Medicare BPCI-A Payment Model (March 21, 2023)
- Frequently Asked Questions (updated November 2022)
- Comparison Table of Bundled Payment Models
- CMS Open Door Forum: Model Overview & Application Process
- Overview: Presentation slides and recording
- Application Process: Presentation slides and recording
- CMS BPCI Advanced Model Web Page
CMS Bundled Payments for Care Improvement Initiative Web Page (Tracks 1-4)
MSSP
CY 2023 Physician Fee Schedule Final Rule
Medicare Shared Savings Program “Pathways to Success” Proposed Rule
MSSP Extreme and Uncontrollable Circumstances Policies for Performance Year 2017 Interim Final Rule
- CHA Comment Letter
Updated ACO Waivers under the MSSP Program (Oct. 2015)