CMS Announces New Voluntary Bundled Payment Model

Posted on January 11, 2018

The Centers for Medicare & Medicaid Services (CMS) announced Jan. 9 the Bundled Payments for Care Improvement Advanced (BPCI Advanced) program, a new Medicare fee-for-service (FFS) voluntary bundled payment model. This program offers participants both upside and downside risk. Participating provider impacts will be based on total Medicare expenditures for qualifying episodes of care compared to predetermined target prices and quality performance.

The BPCI Advanced program will include 29 inpatient and 3 outpatient 90-day clinical episodes. The CMS has selected seven quality measures on which performance will be measured in the program. The All-cause Hospital Readmissions and Advance Care Plan measures are required for all clinical episodes, with the other five measures applying only to select episodes.

The CMS-issued Request for Applications document provides details of the model and explains how applications will be reviewed. Providers interested in participating in this program must submit an application and all required documents to the CMS through the BPCI Advanced Application Portal by March 12. The BPCI Advanced program will begin Oct. 1, 2018, and run through Dec. 31, 2023. The CMS will provide a second application opportunity in January 2020.

Featured in Monday Report. Click to view the full edition.The CMS indicated the BPCI Advanced will qualify as an advanced alternative payment model under the Medicare physician quality payment program. Hospitals and health systems are encouraged to review the details of this new voluntary bundled payment program to determine if it aligns with their healthcare delivery strategies. Members with questions should contact Jason Jorkasky at the MHA.

Tags: Medicare, bundled payment, CMS, BPCI Advanced program

Posted in: Member News

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