What We Learned at The National Bundled Payment Summit

Last week Archway attended The National Bundled Payment Summit in Washington, D.C. Here are some of our takeaways from the conference:

  • CMS is committed to expanding bundled payments in the future both in mandatory programs like CJR and voluntary programs like BPCI.
  • Funding for CMMI continues through 2019. At that time, their funding is renewed for another 10 years automatically unless Congress explicitly acts to terminate that funding.
  • MACRA legislation is likely to play a large role in framing alternative payment programs going forward. In particular, providers who participate in "advanced alternative payment methods" are exempted from MIPS and automatically given the largest possible MIPS bonus. For an APM to qualify as an advanced APM, it must
    • have 2-sided risk,
    • make payments dependent on quality measures, and
    • require the use of certified EHR technology.
  • Although CJR requires that hospitals act as the episode initiators, future programs will also include physicians as episode initiators.
  • Commercial payers and large employers are moving forward with bundled payment programs, but adoption is being hindered by many factors including operational challenges in implementation.
  • The Oncology Care Model, which includes an episode-based payment component, was discussed by CMMI leadership extensively, but oncology groups were generally not present at the conference.