Medicare’s Alternative Payment Models (APMs) have produced annual gross savings ranging from $0.7 billion to $2.9 billion, according to recent data. These models are designed to reward health care providers for delivering high-quality and cost-efficient care by changing payment structures and improving patient access to advanced primary care services.
Participation in APMs requires primary care providers to understand how beneficiaries are attributed, the payment methodology, effective use of performance data, and meeting requirements for care delivery and quality measurement reporting. To address these needs, training and technical assistance (TTA) play a key role in supporting providers as they navigate the complexities of these models.
RTI International has worked with the Center for Medicare & Medicaid Innovation (CMS Innovation Center) over the past eight years to implement APMs in primary care settings. This support included models such as Comprehensive Primary Care Plus (CPC+), Primary Care First (PCF), and Making Care Primary (MCP). RTI provided TTA to more than 6,100 primary care practices participating in these alternative payment models.
A central element of this support was a dedicated help desk for each model. The help desks used a tiered response structure: Tier 1 staff managed ticket logistics, Tier 2 addressed routine inquiries, while Tier 3 subject matter experts handled specialized questions. Policy issues were escalated to CMS when necessary. RTI also developed protocols for tracking and escalating issues efficiently.
Quality assurance and control procedures ensured customer service standards were maintained, including accurate and timely responses and opportunities for customers to acknowledge resolution. Monthly reports on help desk inquiries helped identify participant knowledge gaps and informed educational resource development or policy modifications.
Communication strategies were another important component. Bi-weekly newsletters consolidated essential messages, deadlines, and best practices for health care delivery. General broadcast emails relayed critical updates or policy changes, while targeted communications addressed specific participants’ time-sensitive requirements. System banner messages posted on participant portals communicated important updates or scheduled downtimes.
The impact of outreach communications was measured using metrics such as email performance, newsletter engagement rates, and feedback from satisfaction surveys.
RTI’s TTA framework offered diverse educational resources—including written guides, toolkits, videos, webinars, and office hours—to accommodate different learning preferences among participants. Collaboration with subject matter experts helped ensure materials remained clear and up-to-date. Interactive sessions allowed participants to ask questions in real time.
Participant feedback was gathered through surveys and monitoring help desk tickets to identify learning gaps and improve TTA offerings continuously.
Peer-to-peer collaboration was supported through CMMI Connect—a knowledge-management platform that allowed participants to share experiences and solutions electronically. RTI coordinated with other contractors to manage this platform actively by monitoring discussions, providing timely responses when needed, clarifying information, or redirecting users to the help desk as appropriate.
The platform also served as a searchable library of resources that was updated regularly with FAQs, answers, announcements, and calendars tracking key dates.
According to RTI International’s experience: “Successful participation in Medicare APMs requires an understanding of and adherence to model requirements. Our experience demonstrates that a model-specific help desk, effective communication vehicles and outreach, comprehensive training and resources, and peer collaboration are critical for empowering primary care practices to navigate new payment structures, meet model requirements and, ultimately, improve patient health care.”
These approaches have been foundational in supporting providers under Medicare’s alternative payment models by helping them adapt processes for improved outcomes.
