CMS revealed its new voluntary episode model, Bundled Payments for Care Improvement Advanced, set to start Oct. 1.
Darcie Hurteau, senior director at Rensselaer, N.Y.-based healthcare data analytics and policy firm DataGen, offers insight into what participants can expect under BPCI Advanced as well as what the future holds for bundled payments.
Question: What should providers keep in mind after applying to BPCI Advanced?
Ms. Darcie Hurteau: The deadline for applying to BPCI Advanced is March 12. Practices that want to participate in BPCI Advanced should have completed some important first steps at this point:
• Evaluate your risks and opportunities.
• Assess the strategic buy-in from the rest of your organization's stakeholders.
• Request your data from CMS (this doesn't obligate you to participate).
• Submit multiple applications to keep your options open, depending on any scenarios you are considering as a convener or non-convener.
The decision to participate — for which episodes and under what type of organization — will be finalized with a participation agreement due in August 2018.
Q: What should providers look for in their data after they receive it from CMS?
DH: After providers receive their data from CMS, it needs to be compiled in such a way that you can identify your high-volume episodes, your episode cost drivers and whether or not there is opportunity to reduce those costs. For example, take a look at whether the cost drivers are fixed or variable, whether there is opportunity to change care management activities to reduce post-acute utilization and/or readmissions. Those episodes where there's opportunity for cost reduction are the ones where it might make sense to participate in BPCI Advanced.
Q: What do you see as the future of bundled payments?
DH: With CMS giving people the added incentive of making this an advanced APM, I would expect that while the program is not currently mandatory, over time it will become increasingly disadvantageous for practices not to participate in bundled payment models. This is the direction the industry is headed in, and practices will need to pay attention if they want to stay competitive.
Check out Ms. Hurteau's blog post for 10 key factors BPCI Advanced participants should consider.
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