On October 1, the Centers for Medicare & Medicaid Services (CMS) will roll out its newest bundled payment model, Bundled Payments for Care Improvement Advanced (BPCI Advanced). This voluntary program builds on the foundation of the original BPCI initiative, which began in 2013 and will end on September 30.
The commitment to further testing the potential of BPCI might suggest that CMS believes that the future of value-based payments is in voluntary participation. Factor in the 2017 cancellation of several mandatory bundled payment initiatives, coupled with a reduction in the number of health systems participating in the Comprehensive Care for Joint Replacement (CJR) model, and it’s easy to conclude that moving forward, voluntary programs will become the norm.
However, the confirmation of Alex Azar as Health and Human Services (HHS) Secretary this past January reopened the possibility that, in spite of the earlier actions, mandatory models may still be a viable option… and indeed, recent comments by Azar indicate we’ll see additional mandatory programs down the road.
“We need strategies and models that provide better care at a lower price, not just new models for the sake of new models and not new systems of payment for old systems that aren’t open to real change,” Azar said at a meeting of the Physician-Focused Payment Model Technical Advisory Committee (PTAC) earlier this month. “In some cases that’s going to mean mandatory models from CMMI [Center for Medicare & Medicaid Innovation] and other mandatory reforms.”
As for what models will be subject to mandatory participation, CMS Administrator Seema Verma says the focus will be on high-cost conditions. “We’re looking at end-stage renal disease, cancer care, chronic disease, [and] individuals with serious medical conditions,” she said at the PTAC meeting.
But regardless of whatever future direction bundled payment models take, MedBen Analytics is ready to help hospitals, health systems and other providers achieve positive results from their participation. We work with both voluntary and mandatory models, and the insights offered through our innovative reporting software platform will enable your organization to ensure the highest level of care while unlocking profit potential.
If you’d like to see a demonstration of our system or want additional information about MedBen Analytics, please call MedBen President & CEO Kurt Harden at 888-633-2364 or email medbenanalytics@medben.com.