Home Health Care Nearly 1,300 entities participate in BPCI Advanced model

Nearly 1,300 entities participate in BPCI Advanced model


Geisinger and Dignity Health are among the 1,299 entities that have agreed to take part in the Bundled Payments for Care Improvement — Advanced model, CMS announced earlier this week.

The participants include 832 acute care hospitals and 715 physician group practices in 49 states plus Washington, D.C. and Puerto Rico.

Through the voluntary BPCI Advanced model, organizations will get bundled payments for certain episodes of care instead of receiving fee-for-service payments. The new initiative includes 32 bundled clinical episodes, 29 of which are inpatient and three of which are outpatient. A few inpatient episodes in the program are congestive heart failure, sepsis, stroke and urinary tract infection.

BPCI Advanced qualifies as an Advanced Alternative Payment Model, meaning providers can be exempted from the reporting requirements associated with MIPS.

The new bundled payment model is a five-year program, running from October 1, 2018, to December 31, 2023. It continues the work of the original BPCI initiative, which wrapped up on September 30, 2018.

However, there are a few differences between the old and new programs. For instance, BPCI Advanced offers bundled payments for more clinical episodes than those included in BPCI. Plus, BPCI Advanced gives participants preliminary target prices (or the amount CMS will pay for care episodes) before the beginning of each model year.

“To accelerate the value-based transformation of America’s healthcare system, we must offer a range of new payment models so providers can choose the approach that works best for them,” CMS Administrator Seema Verma said in a statement.

CMS first announced BPCI Advanced in January of this year, shortly after it finalized the cancellation of the mandatory hip fracture and cardiac bundled payment programs.

Photo: aurielaki, Getty Images

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