The Centers for Medicare and Medicaid Services (CMS) is launching a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced).
The new model will qualify as an Advanced Alternative Payment Model (Advanced APM), one of the two performance tracks of the Quality Payment Program under MACRA. Advanced APM providers take on financial risk to earn the Advanced APM five percent incentive payment.
Details on the BPCI Advanced Model
Participants in the BPCI Advanced model will be required to keep Medicare expenditures within a defined budget while maintaining or improving performance on specific quality measures. A few key elements of the model are:
- Physician group practices and acute care hospitals are among those eligible to apply.
- Participants are required to use Certified Electronic Health Record Technology.
- The model includes 29 Inpatient Clinical Episodes such as acute myocardial infarction, major joint replacement, and stroke. It also includes three Outpatient Clinical Episodes, including percutaneous coronary intervention.
- The model offers a single retrospective bundled payment and one risk track, with a 90-day clinical episode duration.
- Preliminary Target Prices will be provided in advance of the first performance period of each model year.
The performance period for BPCI Advanced starts on Oct. 1, 2018, and will continue through Dec. 31, 2023.
How to Apply for BPCI Advanced
Applications for the first cohort of participants must be submitted by 11:59 pm EST on March 12, 2018.
Links to CMS’ application documents are available below:
Once you have completed the application documents, Apply Here.
You can listen to CMS' recorded webcasts for an overview of the BPCI Advanced Model and the application process for BPCI Advanced.
More details about the BPCI Advanced model are available via CMS’ Innovation Center here and via this CMS Fact Sheet. Questions on the model can be emailed to CMS at BPCIAdvanced@cms.hhs.gov.
Pennsylvania Medical Society (PAMED) members with questions can also contact our Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.