As we noted in last week’s special insight edition, the Centers for Medicare & Medicaid Services (CMS) will roll out Bundled Payment for Care Improvement (BCPI) Advanced, a new voluntary bundled payment model, on October 1, 2018. Using the current BPCI initiative and other Center for Medicare and Medicaid Innovation (CMMI) models as its foundation, CMS has taken lessons learned from the earlier programs, in addition to provider input, and used them in the development of the Advanced model.
“BPCI Advanced builds on the earlier success of bundled payment models and is an important step in the move away from fee-for-service and towards paying for value,” CMS Administrator Seema Verma said in a statement. “Under this model, providers will have an incentive to deliver efficient, high-quality care.”
While some of the elements of BPCI Advanced will be familiar to current BPCI participants, CMS has introduced new features to appeal to a greater provider population, as well as offering increased incentives. Among them:
Advanced APM. To further incentivize providers, BPCI Advanced will qualify as an Advanced Alternative Payment Model (APM) under the Medicare Access and CHIP Reauthorization Act’s (MACRA’s) Quality Payment Program. Because participants take on additional financial risk, they can earn a five percent bonus.
Outpatient Care Episodes. Unlike the earlier BPCI initiative, the Advanced model offers participants three outpatient care episodes – Percutaneous Coronary Intervention, Cardiac Defibrillator, and Back & Neck except Spinal Fusion. Meanwhile, inpatient episodes have been reduced to 29 (from the original 48), likely to better focus on those episodes that have demonstrated the greatest provider interest and potential for return.
Applications to participate in BPCI Advanced must be submitted by March 12, 2018 via the CMS Application Portal. If you’re interested in learning more about the new model, the CMS Innovation Center will conduct an hour-long Q&A session on January 30.
MedBen Analytics will be ready to support BPCI Advanced participants with actionable insights beginning with its schedule start this October. 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.