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.
Clinical care is an essential aspect of any successful bundled payment program, and participating providers should work to include their clinicians. In the second installment of our Advice for Bundled Payments blog series, we sat down with two members of our clinical care team; Kemi Okunade and Aimée Bailey. We asked Kemi and Aimée how providers can engage clinicians in their bundled payment program and what to consider when starting a new 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.
Phoenix Heart PLLC is a cardiology group with six offices in the greater Phoenix area, performing a wide range of services for its patients, including percutaneous coronary intervention (PCI), which it offers as part of the Bundled Payments for Care Improvement (BPCI) Advanced bundled payment program.
One of the challenges that Phoenix Heart CEO, Kyle Matthews, faced when introducing the BPCI Advanced program to the group, like many other providers we work with, was getting physicians to buy in. A recent case illustrated how the program not only saves money – it can help improve outcomes, and even save lives.