Analytics and reporting tools can help providers that participate in Alternative Payment Models (APMs) measure the pulse of their program performance and provide helpful insights into their population health and risk levels, as well as uncover the potential for lowering cost and improving care quality.
Generally speaking, APMs are structured such that providers are measured against a benchmark in a given performance year (PY). Depending on the particular APM structure, the providers share in any savings and/or get paid bonuses based on their performance. If they are in a downside risk model, they may also have to contribute to covering the overages against the benchmark. Some APMs, such as Primary Care First and Direct Contracting, provide capitation payments for the beneficiaries that are attributed to that entity.