New APMs, virtual groups a MACRA rule benefit to few

Why This Topic Matters

It helps providers, practice leaders, and coding/compliance professionals understand which payment pathways CMS is expanding, which ones remain limited, and when newer participation options may become available.

Article Sections

1. Advanced APMs in the final Quality Payment Program rule

   Summarizes the final-rule changes related to advanced alternative payment models and their relationship to MIPS under the Quality Payment Program. The section discusses the overall direction of CMS policy and the limited scope of eligible models.

2. Other payer advanced APMs and future model considerations

   Describes CMS’s effort to broaden participation through additional APM categories and future application rounds. It also notes examples of payment models CMS said it may revisit for advanced APM status.

3. Virtual groups

   Introduces the new virtual group option for smaller practices and clinicians under MACRA. The section explains the general availability timeline and why some small practices may be interested in organizing this way.