Scheduled Adjustments in APM Eligibility Criteria under Medicare Access and Children's Health Insurance Program Reauthorization Act
| Year | Eligibility |
|---|---|
| 2019 and 2020 | ≥25% of total Medicare revenue is from a qualified, eligible APM |
| 2021 and 2022 | ≥50% of total Medicare revenue OR |
| ≥25% of total Medicare revenue and 50% of all-payer revenue (eg, Medicaid, private insurers) is from a qualified, eligible APM | |
| 2023 and beyond | ≥75% of total Medicare revenue OR |
| ≥25% of total Medicare revenue and 75% of all-payer revenue is from a qualified, eligible APM |
APM, alternative payment model; OR, odd ratio.