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Center for Medicare and Medicaid Innovation Announce a New Voluntary Bundled Payment Model

Posted 1/17/18 (Wed)

The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) announced the launch of a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced). Under traditional fee-for-service payment, Medicare pays providers for each individual service they perform. Under this bundled payment model, participants can earn additional payment if all expenditures for a beneficiary’s episode of care are under a spending target that factors in quality.

The new model allows organizations to receive bundled payments for up to 32 different clinical episodes that physicians will be held accountable for cost and quality. BPCI Advanced will count as an Advanced Alternative Payment Model (APM) under MACRA's Quality Payment Program.

Applications open for the program on Jan. 11 and close on March 12. With CMS’ non-binding application process, health care systems can, in effect, ‘raise their hands’ for participation up until March 12, as they continue to evaluate the new program.

For more information about the model and its requirements, or to download a Request for Applications document (RFA), the application template, and the necessary attachments, please visit: https://innovation.cms.gov/initiatives/bpci-advanced.

Applications must be submitted via the Application Portal, which will close on 11:59 pm EST on March 12, 2018. Applications submitted via email will not be accepted.

REASONS TO SECURE YOUR OPTION TO PARTICIPATE in BPCI ADVANCED

1. Nothing to lose: Keeping your options open for participation in BPCI Advanced does not bind you to participation. It lets the agency know you that you are considering the program. The binding contract is not due until August.

2. Power to decide: Engaging CMS now gives you the power decide later. Submitting a non-binding application allows you to receive your cost and quality data and target prices to evaluate whether the program is right for you. Once open enrollment closes, there will be no other opportunities to apply for BPCI Advanced until the next open enrollment period in early 2020.

3. Revenue to gain: Practices working with Archway Health in the first generation of BPCI generated on average $3,000 in additional revenue per episode of care. Participation in BPCI Advanced will also allow providers to earn bonuses under MACRA’s Advanced APM track and avoid downside risk under MIPS.

For more information about the model and its requirements, or to download a Request for Applications document (RFA), the application template, and the necessary attachments, please visit: https://innovation.cms.gov/initiatives/bpci-advanced.

 

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