On January 9, the Centers for Medicare & Medicaid Services (CMS) formally announced the introduction of Bundled Payments for Care Improvement Advanced (BPCI Advanced), a new voluntary episode payment model. MedBen Analytics, which has provided insightful reporting services for voluntary and mandatory bundled payment models since 2015, will support the new initiative for health systems and providers electing to participate.
BPCI Advanced builds on the foundation of the original BPCI initiative, which began in 2013 and is scheduled to run through September 30, 2018. The new model “aims to support healthcare providers who invest in practice innovation and care redesign, better coordinate care, improve quality of care, and consider the financial implications of their treatment decisions,” CMS said in a press release.
BPCI Advanced will start on October 1, 2018 and run through December 31, 2023. According to CMS, its model design elements include:
- A voluntary episode payment model that qualifies as an Advanced Alternative Payment Model (Advanced APM);
- A single payment and risk track with a 90-day post-discharge or post-procedure episode period;
- 29 inpatient clinical episodes;
- 3 outpatient clinical episodes;
- Payment tied to performance on quality measures; and
- Preliminary Target Prices provided prospectively.
MedBen Analytics will draw on its knowledge of Medicare data consolidation and analysis — backed by 80 years of experience in medical claims management — in the development of software for the BPCI Advanced model, said MedBen President and COO Kurt Harden.
“MedBen Analytics helped our clients thrive under the initial BPCI model,” Harden said. “We anticipate the Advanced model will be a major step forward in value-based care, and look forward to giving participants the insights necessary to achieve success.”
Request for Applications to participate in BPCI Advanced are available at the BPCI Advanced website. CMS says that additional introductory materials will soon be available on the site as well.
MedBen Analytics will provide further information and share observations on the new model as we receive it. In the meantime, if you have any questions or are interested in viewing a demo of our current reporting platform, please contact Harden at 888-633-2364 or email kharden@medben.com.