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BPCI Advanced
BPCI Advanced

BPCI Advanced

You need to decide quickly whether the new Bundled Payment for Care Improvement Advanced (BPCI Advanced) program is right for your hospital or physician group.

Applications are due March 12, 2018. Contact Veralon at VBP@veralon.com for assistance.

BPCI Advanced is worth considering. Our BPCI clients have been successful in achieving overall average savings of 15%, by reducing readmissions by up to 45% and decreasing SNF stays up to 30%.

 

Here’s a short primer about the program and a guide to key upcoming decisions.

About BPCI Advanced

BPCI Advanced is a voluntary program that allows hospitals and/or physician groups to manage episodes and receive financial rewards.

  • BPCI Advanced qualifies as an Advanced Alternate Payment Model under MACRA, allowing physicians to access the 5% bonus and avoid MIPS
  • Like the original program, BPCI Advanced has downside risk
  • In addition to 29 inpatient bundles, there are three outpatient bundles (See list)
  • All bundles will be for 90-days
  • Quality scores could decrease financial rewards by up to 10% for the first two model years

Key Decisions

Applicants must apply by March 12th, analyze target prices in May, and select episodes, if any, by August 2018. Participants are not obligated unless they choose to sign up in August.

Between now and March 12th, potential participants must:

  • Decide whether to apply (non-binding)
  • If you are applying with a convener, consider also applying independently to keep your options open
  • Plan application content
  • Manage physician group decisions on whether to participate with the hospital or pursue on their own

To learn more about how Veralon can support your evaluation of BPCI Advanced, contact VBP@veralon.com or call 877-676-3600.

HOW VERALON CAN HELP

Veralon has years of experience in supporting clients with bundled payment and shared-risk arrangements. We can help your organization win with BPCI Advanced, in any or all of the following ways:

During the Application and Evaluation

  • Complete a preliminary assessment to decide about applying to get the data
  • Assist in writing your application before March 12th
  • Obtain and analyze the Medicare data to understand your position in the market and evaluate the benefits and risks
  • Select episodes that are likely to be successful
  • Manage physician relationships (whether as associates or if they plan to pursue on their own)
  • Provide guidance on the care redesign process and design care improvement initiatives

During the Performance Period

  • Analyze claims, cost accounting, financial, and quality data to identify opportunities for improvement on selected conditions
  • Share best practices based on bundled payment expertise
  • Select the right post-acute care partners based on data-driven decision making
  • Provide our interactive web-based financial management tool, Quanto, so you can monitor cost drivers, top performers, and partners on an ongoing basis
  • Structure a working committee, and present financial results at steering committee meetings
  • Design and administer gainsharing models

Veralon clients are successful with bundled payment. For example, our clients have achieved average savings of 15% savings, reduced readmissions up to 45%, and decreased SNF stays up to 30%. Our clients have also had wins in both surgical and medical bundles. Furthermore, we do not take a piece of your earnings.

Other Resources:
Additional information on BPCI Advanced is available at the CMS website: https://innovation.cms.gov/initiatives/bpci-advanced/