CMS to Accept 2020 BPCI Advanced Applications in April

Posted on March 28, 2019

In April, the Centers for Medicare & Medicaid Services (CMS) will begin accepting applications to participate in the second cohort of the Bundled Payments for Care Improvement Advanced (BPCIA) model, which will begin Jan. 1, 2020. The first cohort of this model includes 29 inpatient and three outpatient bundled clinical episodes; it began Oct. 1, 2018, and runs through Dec. 31, 2023. The CMS currently does not intend to allow providers to enroll in 2021 and 2022.

BPCIA participants assume risk for patients' healthcare costs and can qualify for incentive payments. By meeting certain quality and other requirements, they can also qualify for exemption from reporting requirements under Medicare's quality payment program for clinicians. Acute-care hospitals and physician group practices may apply as:

  • Conveners, which means they assume risk for multiple downstream clinical episode initiators. Post-acute care providers and accountable care organizations may apply to participate as conveners.
  • Nonconveners, which means they initiate clinical episodes under the model.

BPCIA participants could withdraw completely or from selected bundled episodes with no financial risk through March 1, and 715 acute-care hospitals and 580 physician group practices are currently participating.

The CMS is finalizing the selection of new clinical episodes for 2020, which will include outpatient total knee arthroplasty. Additional information and an updated list of participants, episode initiators and clinical episode selections for 2019, is available on the CMS website. Members with questions should contact Vickie Kunz at the MHA.

Tags: bundled payments, BPCI Advanced, Bundled Payment for Care Initiative Advanced

Posted in: Member News

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