Why CMS Alternative Payment Models Are Failing

The reason CMS Alternative Payment Models (APMs) are failing to significantly reduce spending in Medicare is that none of the major APMs meets the majority of the eight criteria for a successful APM.  The Problems with Medicare’s Alternative Payment Models and How to Fix Them details the serious weaknesses in the six major Advanced APMs that have been implemented by CMS and the CMS Innovation Center:

• Bundled Payments for Care Improvement Advanced (BPCI-A);
• Comprehensive Care for Joint Replacement (CJR);
• Comprehensive End Stage Renal Disease Care (CEC);
• Comprehensive Primary Care Plus (CPC+);
• The newly adopted Basic Track Level E and Enhanced Track in the Medicare Shared Savings Program (MSSP); and
• The Oncology Care Model (OCM).

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