MIPS would tie payments to a score providers earn based on a number of performance measures.

Half of the score would be tied to the quality of care, which itself would be based on six different metrics, depending on the medical specialty. One common metric for evaluating quality is the rate at which patients are readmitted to the hospital within a month of an operation.

MIPS would also credit providers for adopting new technology, reducing costs, and making various improvements to their practice.

The AAPMs are intended for providers that come up with an alternative to the current fee-for-service model and the MIPS framework. Medicare is thus allowing providers to propose their own alternative payment models tailored to their specialties and practices if they can show that the model is superior to the status quo.

Now that HHS has submitted the rule, the public has until June 26 to provide comments in response.

“We have more work to do, but we are committed to implementing this important legislation and creating a health care system that works better for doctors, patients, and taxpayers alike,” said HHS Secretary Sylvia Burwell in a statement. “We look forward to listening and learning from the public on our proposal for how to advance that goal.”