APC-APM for Delivering Patient-Centered Care

The Advanced Primary Care-Alternative Payment Model (APC-APM) embodies the principle that patient-centered primary care is comprehensive, continuous, coordinated, connected, and accessible from the patient’s first contact with the health system. The APC-APM aims to improve clinical quality through the delivery of coordinated, longitudinal care, and uses the approach to deliver care that improves patient outcomes and reduces health care spending.

The APC-APM is envisioned as a multi-payer model that builds on concepts already tested through the Comprehensive Primary Care (CPC) and CPC Plus (CPC+) initiatives. The APCAPM would be open to almost 200,000 primary care physicians and potentially impact more than 30 million Medicare patients. Based on available evidence, additional spending on primary care is projected to be more than offset by savings elsewhere in the health care system, resulting in a net savings to the payers involved.

Each APC-APM entity will be evaluated based on reporting six measures, with one being an outcomes measure in order to align with the Medicare Access and CHIP Reauthorization Act’s (MACRA’s) Merit-based Incentive Payment System (MIPS) reporting requirements. These measures will come from the core measure sets developed by the multi-stakeholder Core Quality Measures Collaborative to ensure focus, alignment, harmonization, and the avoidance of competing quality measures among all payers. These measure sets include patient experience measures, and all but one of the core measures are also measures under the MIPS.