EOM Participants must take downside risk for all performance periods.
They will choose from one of two risk arrangement (RA) options:
RA 1:
To qualify for savings, participants must reduce expenditures by more than 4% off the benchmark (96% of the benchmark, or the “target price”).
Participants can qualify for up to 4% savings below the target price (92% to 96% of benchmark).
Participants take up to 2% risk (98% – 100% of benchmark).
Safe Zone, or “Neutral Zone:” No risk from 96% – 98% of benchmark.
Qualifies as a MIPS APM. Does not qualify as an Advanced APM.
RA 2:
To qualify for savings, participants must reduce expenditures by more than 3% off the benchmark (97% or the “target price”)
Participants can qualify for up to 12% savings below the target price (85% – 97% of benchmark)
Participants take up to 6% risk (98% – 104% of benchmark).
Safe Zone, or “Neutral Zone:” No risk from 97% – 98% of benchmark.
Qualifies as a MIPS APM and an Advanced APM.
Risk Bearing Entities:
Participants must comply with State-specific risk-bearing regulations, as applicable.
Source: https://innovation.cms.gov/innovation-models/enhancing-oncology-model
