CMS Launches New Voluntary Bundled-Payment Model

January 2018 ~

CMS on January 8th introduced its new voluntary bundled payment model, Bundled Payments for Care Improvement Advanced (BPCI Advanced).

CMS said it designed the new model to take into account rigorous evaluation results from previous CMMI (Center for Medicare and Medicaid Innovation) models, industry experience with bundled payment, and stakeholder input from healthcare providers at acute care hospitals, physician group practices, and other providers and suppliers.

According to the announcement, the model will qualify as an Advanced Alternative Payment Model (Advanced APM) under MACRA’s Quality Payment Program, in which providers take on risk to earn the payment incentives.

CMS states the BPCI Advanced model will enable participants to earn additional payments for a beneficiary’s episode of care if quality is maintained while the cost comes in under a spending target. The Agency noted that bundled payments “create incentives for providers and practitioners to work together to coordinate care and engage in continuous improvement to keep spending under a target amount.”

Participants can receive payments for 32 clinical episodes of care, including major joint replacement and a coronary intervention. These clinical episodes add outpatient episodes to the inpatient episodes that were offered in CMMI’s previous bundled payment model (the Bundled Payments for Care Improvement initiative).

“CMS is proud to announce this administration’s first Advanced APM,” CMS Administrator Seema Verma said in a statement. “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. Under this model, providers will have an incentive to deliver efficient, high-quality care.”

CMS is looking for participants to take part in the model, set to begin October 1st, 2018, and run through December 31st, 2023.

For more information, refer to CMS’ BPCI Initiative General Information page.



Source(s): Modern Healthcare; Healthcare Dive; Becker’s Hospital Review; CMS Press Release; Health Data Management;