Table 1:

Comparing the Merit-Based Incentive Payment System to Advanced Alternative Payment Models

	Merit-Based Incentive Payment System	Advanced Alternative Payment Model
Eligibility	After 2020, most Medicare fee-for-service providers	Bear more than nominal financial risk (usually 2-sided) Use certified EHR technology
Incentives and Penalties	Payments up- and downward adjusted using a composite performance score: Quality Cost Use of certified EHR Clinical practice improvement activities Exceptional performers receive up to 10% bonus	5% Annual lump-sum bonus Eligible for shared savings and losses Quality measures comparable to MIPS Exempt from MIPS
Fee Schedule Update (after 2026)	0.25% annual baseline payment update	0.75% annual baseline payment update

Notes: Adapted from data from Matousek, et al, 2016.⁵³ Abbreviations: EHR = electronic health record, MIPS = Merit-based Incentive Payment System.