The Alternative Payment Model (APM) Framework is composed of closed-ended questions introducing areas of focus within four categories – Organizational Readiness, Clinical Practice Transformation, Reporting and Analytics, and Financial Risk – that ACC members should consider when evaluating participation in an APM. The categories are modular, enabling users to self-select criteria applicable to their practice environment.

The framework was developed to guide ACC membership through the most critical implications the cardiology community should consider when evaluating APM participation. Future consideration for development of a cardiovascular specialty or disease-focused APM may be revisited.

Organizational Readiness

Approaches to value-based payment strategies, external partnerships, workforce requirements and other foundational concepts must be fully considered and understood prior to APM participation.

Clinical Practice Transformation

Creating patient access, coordinating care for patients along the continuum, engaging patients to support their care plan and defining high risk patients are critical factors for success in APM arrangements.

reporting and analytics

Reporting and analytics are foundational for value-based payment arrangements. External reporting for sharing performance improvement information and analysis to remediate gaps in performance are required by Federal and commercial payers for organizations participating in APMs.

Financial Risk

Practices should be able to describe the financial risk in different APMs, including differences between upside and downside risk. Consider risk mitigation for business and performance risk within APMs for optimum financial success.