Healthcare

With mandatory programs on the horizon, the voluntary Bundled Payments for Care Improvement Advanced (BPCI-A) program offers early access to data and valuable experience in redesigning patient care. But with applications closing June 24, 2019, healthcare organizations will need to make some quick decisions about participating in this voluntary Medicare bundled payment program.

“We want to pay for outcomes, not process ... We need results, American patients need change, and when we need mandatory models to deliver it, mandatory models are going to see a comeback.”

Bundled Payments for Care Improvement-Advanced (BPCI-A) is one of the latest evolutions of value payment methodologies to come from the Centers for Medicare and Medicaid Services (CMS). The roots of BPCI-A are in the original bundled payment demonstration project, the Acute Care Episodes (ACE) program of 2009, which shares an underlying theme that a single, bundled payment for all providers for a defined episode of care will promote efficiency of care, coordination of care and improvement in the quality of care. CMS would like to see higher quality performance paired with lower expenditures in these identified patient populations.

The final phase of CMS’ voluntary Bundled Payments for Care Improvement Advanced (BPCI-A) application process is finally here. Whether your hospital or physician practice intends to participate in the model beginning October 1 (or in a future year) or you are a healthcare attorney advising an organization that intends to participate, CMS’ recent announcements regarding the model are noteworthy.