Advanced APM does not eliminate macra reporting

In fact, you may be doing more MACRA work because of Two-Sided Risk

It all depends on which patients show up for appointments, for each EC.  The only way to know is to check with QPP regularly


  1. Under Advanced APM (Two-sided Risk), MSSP ACOs will need to check providers against the CMS QPP database regularly to determine each individual provider status.  While the basic status of QP has no MIPS filing requirements, some providers will be tagged as Partial QP, and other could be tagged as MIPS Providers, completely outside the QP rulings.
  2. Any provider not a QP will be exempt from the automatic 5% positive adjustment associated with Advanced APM
  3. Partial QPs may choose to submit MIPS data.  If your scores are good, they should do so.  Failure to submit carries no penalties, but does not earn positive dollars either. 
  4. Good news! Partial QP's can actually earn a bigger Financial Adjustment than the 5% grant to QPs!
  5. Provider status is based on claims data throughout the year, and on whether specific patients are in Medicare risk-based payment plans.  This is typically out of the provider's control and difficult to predict.   


Take a look at our Advanced APM software and service offerings.  We'll make the extra work go away, and put you in the position you thought you would be, of eliminating MIPS analysis and reporting.  


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even advanced apm's need monthly macra optimization

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You can't optimize MACRA at Year End

Improving MACRA Metrics comes from a regular program, throughout the year.  We get started as soon as a full month's data is available, and follow a regimen of extract, report, analyze and plan and act for every month thereafter.