CMS extends BPCI participation option to September 2018: 5 key notes

Billing & Coding

Bundled Payments for Care Improvement participants can now extend participation in Models 2, 3 and 4 through Sept. 30, 2018.

Here are five key notes:


1. The first awardee cohort in Models 2, 3 and 4 — those that began in October 2013 — were scheduled to end participation in September 2015. However, they are able to extend participation with other organizations that joined in later years.


2. CMS will provide more robust and rigorous evaluation of BPCI to determine whether efforts are successful in providing better care and spending more wisely as a result of the expansion.


3. BPCI had 1,522 participants as of April 1, 2016 and includes 321 awardees and 1,201 episode initiators. Participants in Models 2, 3 and 5 can choose from 48 clinical episodes.


4. The bundled payment for services across the episode is designed to encourage physicians, hospitals and other providers to coordinate care better when they are in the hospital and after discharge.


5. BPCI hopes to improve healthcare by paying providers for "what works" and finding new ways to coordinate and integrate care while reducing costs.


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