CMS has recently released bundled payment information to acute care hospitals and physician group practices who applied for the program in March of this year, to enable them to decide whether to participate in the new BPCI Advanced program. The Agency has provided preliminary target prices as well as three years of Medicare claims data to support these facilities in their decision-making. Applicants will also be receiving participation agreements from the Agency this month, and Decisions on whether to participate in BPCI Advanced and for which clinical episode groups must be made by August 1. A final selection of applicants will be made by CMS in September and the program will begin October 1, 2018.
BPCI Advanced differs from the prior BPCI program in several ways, but one important difference is that participants will be locked into their initial decisions until January 2020. This means that they cannot add or withdraw clinical episode groups until then. Therefore, applicants need to quickly and carefully assess the information provided to make sound decisions before August 1. Dobson | DaVanzo in conjunction with Dixon Hughes Goodman have developed tools to assist applicants mine the data provided by CMS, evaluate opportunities, understand risks and success factors, and make participation decisions.
For hospitals and physician groups that did not apply, as well as applicants that decide now is not the right time for them to participate, another opportunity to apply to participate in BPCI Advanced will come in the spring of 2019. The facilities selected from this second round of applicants will begin program involvement in January 2020. The level of BPCI Advanced participation could very well decide the future of bundled payments.