CMS Launches Medicare Advantage Qualifying Payment Arrangement Incentive Demonstration

The Centers for Medicare and Medicaid Services (CMS) is launching the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration. MAQIis designed to test whether exempting merit-based incentive payment system (MIPS)-eligible clinicians who participate to a sufficient degree in certain payment arrangements with Medicare Advantage Organizations (MAOs) from the MIPS reporting requirements and payment adjustment will increase or maintain participation in payment arrangements similar to advanced alternative payment models (APMs) with MAOs. In addition, it is designed to test whether it will change the manner in which clinicians deliver care. Specifically, the demonstration will test whether:

• There is an increase in clinician participation arrangements with MAOs that meet the criteria of qualifying payment arrangements;
• Participating in qualifying payment arrangements and advanced alternative payment models to the degree required to be eligible for the demonstration waiver incentivizes providers to transform their care delivery (assessed by interviews with participating clinicians);
• There is a change in utilization patterns among participants in the demonstration; and
• If there are changes in utilization, how those changes affect Medicare Advantage plans.

The MAQI demonstration, which will be tested under the authority of Section 402 of the Social Security Amendments Act of 1967, began in 2018 and will last for five years.