Since the very first cohort of the CMS original Bundled Payments for Care Improvement (BPCI) initiative began in 2013, we’ve seen a lot of providers begin participating in the BPCI and BPCI Advanced programs, with varying levels of success. One thing that separates the best from the rest is knowing what to do with the data.
For BPCI Advanced Model Year 3, some recently announced program updates will bring more incentives and value to all participants – particularly cardiologists. These changes reward cardiology providers for making the best decisions for patients. We commend CMS for better aligning financial incentives with improved care, and we are proud to have advocated to CMS for both of these changes.
Beginning with the start of Model Year 3 on January 1, 2020, when providers in Enhanced ACOs treat patients in a BPCI Advanced bundle, the BPCI-A bundle patient will be attributed to the owner of the bundle and not the ACO. This is an amendment to earlier CMS policy, which attributed these patients to the Track 3 ACO. NextGen ACOs will still take precedence over the BPCI-A program.
Momentum toward a future dominated by value-based payment programs continues with CMS regularly launching new alternative payment models, with a greater emphasis on two-sided risk. Given that value-based payment methodology often includes peer comparisons, those who wait to be dragged along will find themselves at a disadvantage when the voluntary option is replaced by mandatory participation.
For the inaugural edition of our “Advice for Bundled Payments” blog series, we sat down with our CEO and Co-founder, Dave Terry. Dave has spent more than 20 years in healthcare, developing skills and a passion for helping change the way physician groups and health systems manage care and risk through payment reform. We asked Dave about his thoughts on the healthcare industry as a whole and how bundled payments fit into its future.