CMS to Release Preview Target Price Summary Workbooks

On May 17, CMS hosted a webinar on the BPCI Advanced Pricing Methodology. During the webinar, CMS provided a detailed overview of the steps involved in setting BPCI Advanced Target Prices, and some new information on the pricing methodology including the use of a compound lognormal distribution to account for a provider’s patient case mix. 

Archway is excited by the granularity CMS will use in setting prices in BPCI Advanced, as it aims to encourage both high- and low-cost providers to participate and incentivize the delivery of high-value care.  
At the conclusion of the webinar, CMS announced they will soon be releasing Preview Target Price Summary Workbooks that contain a detailed breakdown of all relevant Target Price components. While these Preview Workbooks contain sample data only, the provision of these workbooks allows Archway to fully understand the program pricing methodology and data parameters in advance of receiving real data and target prices later this month. Components included in the workbooks include:
•    Peer group characteristics and spending trends used to construct PAT factors  
•    Risk Adjustment parameter estimates from the baseline period   
•    Patient-level characteristics by bundle category and patient covariates at the Episode Initiator level
•    Physician group practice (PGP) offset calculations for low- and high-cost PGPs

Archway is hosting a webinar next week on these topics and encourage you to join to learn more. Archway’s Chief Analytics Officer, Mah-J Soobader, Ph.D., MPH, will discuss the implications of the Workbook detail.

Register now for Archway’s next BPCI Advanced webinar on Thursday, 5/24, 1:30 – 2:30 pm EST.