Should You Participate in BPCI Advanced?

This month, CMS launched Bundled Payments for Care Improvement Advanced (BPCI Advanced), a new iteration of voluntary bundled payments for 32 clinical episodes designed to reduce costs and improve patient care. Demonstrating the government’s continued support for exploring new payment methodologies, this model represents an opportunity for health care providers to improve quality and profitability across the continuum of care for a range of medical conditions.

BPCI Advanced, like other bundled payments, is designed to incentivize providers who assume risk and accountability for the average cost per case across the continuum of care from admission to 90-days post-discharge. Based on a target price calculated by CMS, the variance from that target price determines whether participants will pay a capped penalty - if they exceed the target price or will receive a payment - if they reduce their average cost per case over a sixth month period. For many health systems, with a concerted improvement plan in place, the reward can be well into the millions of dollars in reconciliation payments.

With the March 12 application deadline fast approaching, health systems are currently exploring the possibility of participating in this new voluntary bundle. To help inform their decisions, data scientists from Avant-garde Health have aggregated the CMS post-acute care data and calculated potential cost savings for each health system. We are offering free evaluations for any health systems who would like an analysis of their benchmarked post-acute care spending. We are also welcoming Harvard Business School Professor Robert Kaplan, a leading voice on value-based care for a BPCI Advanced webinar on January 31st from 2-3pm EST. Registration is open to all providers exploring BPCI Advanced.