Which statement best describes an Advanced Alternative Payment Model (AAPM) under MACRA?

• A. An eligible model with sufficient risk-sharing and quality performance, such as certain ACOs, BPCI Advanced, or similar initiatives.
• B. A model with no risk-sharing and limited quality metrics.
• C. A model applicable only to outpatient clinics.
• D. A model determined by each hospital without MACRA criteria.

Answer: (A)

Advanced APMs are payment models under MACRA that require participants to take on meaningful financial risk in exchange for potential rewards, and they must meet explicit quality performance standards. This combination—substantial risk-sharing plus quality measures—defines an eligible Advanced APM, such as certain ACO arrangements with shared savings and downside risk or programs like BPCI Advanced. Because of these criteria, clinicians in these models can qualify for MACRA incentives and may be exempt from MIPS. Models with no risk-sharing or only limited quality metrics don’t meet the Advanced APM criteria, and models limited to outpatient clinics or decided arbitrarily by a hospital without CMS criteria wouldn’t qualify.