CMS has announced regions where qualifying specialists will be mandated to participate in the new Ambulatory Specialty Model (ASM) for heart failure. Cardiologists in these selected regions who annually treat 20 or more heart failure (HF) patients covered by traditional Medicare will be required to participate in ASM for HF.
The following geographic areas of Georgia were selected:
| 12020 | CBSA | GA | Athens-Clarke County, GA |
| 12054 | Metropolitan Division | GA | Atlanta-Sandy Springs-Roswell, GA |
| 16860 | CBSA | GA | Chattanooga, TN-GA |
| 20060 | CBSA | GA | Douglas, GA |
| 23580 | CBSA | GA | Gainesville, GA |
| 42340 | CBSA | GA | Savannah, GA |
| 45700 | CBSA | GA | Tifton, GA |
ASM is a five-year specialty model designed to test whether episode-based accountability for chronic conditions can improve outcomes and reduce cost of care beginning on January 1, 2027. Based on the MIPS program, ASM for HF is a two-sided risk model that will evaluate individual clinician performance based on specific quality and cost measures, improvement activities, and promoting interoperability. Evaluation of performance in ASM will positively or negatively impact the totality of participant’s Medicare Part B payments by as much as 9%.
CMS plans to release a preliminary list of participants in the coming weeks. ACC encourages our members to begin their education and preparation steps as soon as possible. For more details on AMS for HF, visit the ACC webpage for Ambulatory Specialty Model For Heart Failure – American College of Cardiology.