In Performance Year 5 of the Demonstration (October 1, 2016–September 30, 2017), the Centers for Medicare & Medicaid Services (CMS) found that the actual expenditures for IAH practices’ applicable beneficiaries were approximately 8.4 percent (equating to $33.5 million) below their spending targets, an average reduction of $2,711 per beneficiary. Thirteen out of the 14 IAH practices reduced the per-beneficiary-per-month (PBPM) expenditures relative to the practice’s PBPM spending target.
For Performance Year 5, CMS will provide incentive payments to eight practices (as shown in Table 1) that met the requirements for an incentive payment and whose actual expenditures for applicable beneficiaries were less than 5 percent less than their estimated spending target, for an aggregate amount of $6,855,823. Thirteen out of the 14 IAH practices met three or more of the six quality measures; three of those practices met the performance thresholds for all six quality measures. A total of 12,360 beneficiaries were enrolled in the Demonstration at 14 participating practices (13 practices and 1 consortium consisting of 3 practices). More
