Helping CMS Implement the Alternative Payment Model Track of the Quality Payment Program

Each year, Mathematica and a subcontractor, RTI International, determine which alternative payment model (APM) participants are eligible for a lump-sum incentive payment equal to 5 percent of revenue from covered services from the previous year. Mathematica and RTI also determine which payment models in the CMMI portfolio are eligible APMs, prepare quality performance category scores for APM entities, and assess improvement activities within APMs. In addition, we conduct a variety of ad hoc analyses, provide monitoring reports each quarter, review Physician-Focused Payment Model proposals, and help determine special statuses for clinicians who are eligible for the Merit-Based Incentive Payment System.