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.
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.
Alternative payment models (APMs) are growing in popularity among providers aligning with value-based care. More than a third of healthcare payments were tied to APMs in 2017 – an increase of 5% from just two years earlier. Yet for many clinicians, the thresholds required to become a Qualified Professional (QP) under MACRA’s Quality Payment Program (QPP) are unattainable. Fortunately, the Merit-Based Incentive Payment System (MIPS)-APM Scoring Standard allows providers to use programs like BPCI Advanced to realize the benefits of APMs under MIPS.