During our day together we’ll discuss Quality Initiatives, HIPAA, Artificial Intelligence, and more to ensure that clinicians, hospital and ambulatory administrators, and clinic staff are well prepared for the challenges of modern healthcare.
Lexington, Kentucky – Join Us in Person or Online
CMS’s New Mandatory Ambulatory Specialty ModelThe Center for Medicare & Medicaid Services (CMS) recently released the participant list for the new Ambulatory Specialty Model (ASM). This payment model gauges individual clinician-level performance around high-cost chronic conditions.
Included in this MANDATORY model is a dual-sided risk component designed to increase specialty provider accountability through the co-management of Medicare beneficiary’s care.
Several Kentucky healthcare providers have been selected to participate in this MANDATORY model.
A list of selected providers can be found on the CMS Model website. Visit this link to determine if you are a required participant in the ASM
If you are a specialist managing patients with heart failure or low back pain, the time to understand your obligations is now.
Click this link to visit CMS’s Ambulatory Specialty Model website to learn more or contact your Kentucky REC advisor at 859-323-3090 to learn about our ASM operational and strategic support services.
Questions about eligibility and practice impacts from this new MANDATORY payment model? Contact YOUR Experts at the Kentucky REC for all your ASM questions. Call us at 859-323-3090 or email us kyrec@uky.edu.
The Centers for Medicare & Medicaid Services (CMS) recently released the Initial Participation list for clinicians required to take part in the newly finalized Ambulatory Specialty Model (ASM) — a significant shift in how specialty care is delivered and reimbursed in Traditional Medicare.
Several Kentucky healthcare providers have been selected to participate in this MANDATORY model. Visit this link to determine if you are a required participant in the ASM
These impact registration and limit access to critical information through the ASM Participant Portal. Here is the ASM Participant Contact Information Form.
If you are a specialist managing patients with heart failure or low back pain, the time to understand your obligations is now.
Click this link to visit CMS’s Ambulatory Specialty Model website to learn more or contact your Kentucky REC advisor at 859-323-3090 to learn about our ASM operational and strategic support services.
The ASM is designed to improve the co-management of Traditional Medicare beneficiaries while driving down costs within defined clinical episodes. Unlike many prior payment models, this is an individual provider-level model. It places the responsibility for cost and quality directly on the MDs and DOs who manage high-cost chronic conditions.
Duration: Five years, beginning January 1, 2027, and concluding December 31, 2031.
Escalating Risk: Participants will face a dual-sided risk profile starting at 9% and increasing to 12% over the life of the model.
The Bottom Line: The ASM represents a move toward granular accountability. Specialists are no longer on the sidelines of value-based care—they are now a vital part of it.
Questions about eligibility and practice impacts from this new MANDATORY payment model? Contact YOUR Experts at the Kentucky REC for all your ASM questions. Call us at 859-323-3090 or email us kyrec@uky.edu.
Health Center Individualized Technical Assistance Program for PCMH RecognitionThe Health Center Individualized Technical Assistance (TA) Program, funded by HRSA, offers personalized one-on-one support to HRSA-supported health centers and Look-Alikes that are not yet Patient-Centered Medical Home (PCMH) recognized, but are ready to pursue this important credential. Through this program, health centers receive individualized guidance from NCQA PCMH Certified Content Experts (CCEs) to help navigate PCMH requirements and successfully achieve Recognition. CCEs are supported by HRSA funding for their work with participating centers.
According to NCQA, Patient-Centered Medical Home recognition research shows this program improves quality and patient experience, and increases staff satisfaction, while reducing health care costs. It can also prepare your organization for building the foundation for Value-Based Care. The NCQA PCMH program is the most widely adopted program in the United States and has more than 10,000 recognized practices.
If your health center chooses to participate and is approved, then you may select a PCMH Certified Content Expert (CCE) of your choice to assist during the recognition process.
The Kentucky REC’s PCMH Team Lead, Vance Drakeford, may be selected as the CCE from the available options. Vance has assisted over 50 healthcare organizations, including FQHC’s to achieve PCMH recognition.
Take the next step in improving services to your patients as well as employee satisfaction!
Questions? For more information on how to begin this process, or further details, contact YOUR experts by email at KYRec@uky.edu or call us at 859-323-3090. We’re here to help.
Centers for Medicare & Medicaid Services (CMS) recently opened the Quality Payment Program (QPP) data submission portal for the 2025 performance period. The portal will remain open until 8 pm ET Tuesday, March 31st, 2026.
Check out the mini video at the bottom of this blog post for a brief overview of what you need to do.
Eligible Clinicians must submit data for three of the four categories for the Merit-based Incentive Payment System Program (MIPS) to earn anywhere between a negative or positive 9% payment adjustment impacting Medicare Part B payments in calendar year 2027. If a clinician is eligible and submits no data, they will automatically receive a negative 9% payment adjustment.
Alternative Payment Model (APM) participants may submit data through the QPP Portal during this window.
Clinicians or their designee should verify that access to the organization’s QPP Portal is active and up to date. Users without a log-in to this portal will need to request access through the HCQIS Authorization Roles and Profile (HARP) system prior to submission by following the link here: https://qtso.cms.gov/access-forms/harp-account-registration
Data submission for each of the categories requires different time periods for data collection:
Clinicians may use various methods for submitting data to each category:
Each of these methods have specific rules that govern their use. Clinicians are encouraged to review those methods before attempting to attest.
Our advisors strongly recommend submitting data well in advance of the deadline to allow time for data validation or necessary updates within the QPP portal system.
In the coming weeks, the Kentucky REC advisors will be contacting clients to assist with data finalization, reviewing attestation checklists, and gathering audit support materials.
Not a client? Contact YOUR Experts at the Kentucky REC for all your QPP & APM questions. We’re here to help. Call us at 859-323-3090
QPP 2026 PFS & QPP Final Rule*
Webinar Date: December 16, 2025 @12pm
CMS released the highly anticipated 2026 Physician Fee Schedule (PFS) Final Rule on Nov 3rd — and the changes are significant.
From new Quality Payment Program (QPP) requirements to critical updates impacting MIPS Value Pathways (MVPs) and Alternative Payment Models (APMs), eligible clinicians will see meaningful shifts in reporting, participation, and performance expectations.
One of the most notable updates is the introduction of the new Ambulatory Specialty Model (ASM)—inclusion of specialists in outpatient and ambulatory care settings. ASM is designed to expand value-based care opportunities, improve quality measurement alignment for specialists, and offer new pathways to succeed in advanced payment arrangements.
OUR TEAM OF EXPERTS WILL WALK YOU THROUGH:
• Key QPP updates every organization must understand
• What’s changing within MVPs and APM participation
• How the Ambulatory Specialty Model will affect specialists and reporting options
• Action steps to prepare for 2026
Interested in learning more about QPP, attend upcoming webinars, or learn how our advisors can assist your practice in maximizing performance in the QPP or other value-based care programs? As a client, you receive exclusive access to our analysis of all aspects of the Quality Payment Program. To speak with the team on how we can best support you, feel free to contact us HERE.
*This webinar is for Kentucky REC contracted QPP clients only. If you are interested in this topic and would like to learn more about becoming a client, please contact us at (859) 323-3090 or email us at KYRec@uky.edu. We aim to be your trusted healthcare advisor!
