The Centers for Medicare & Medicaid Services (CMS) is implementing a new voluntary bundled services payment model for Medicare.
“BPCI [Bundled Payment for Care Improvement] Advanced builds on the earlier success of bundled payment models and is an important step in the move away from fee-for-service and towards paying for value,” CMS administrator Seema Verma said Tuesday.
But the Trump administration has resisted mandatory bundled care models. Indeed, last November CMS canceled mandatory bundled care payment models for hip fractures and cardiac care, and reduced the number of regions required to participate in a bundled-care payment system for joint replacement.
Carter Paine is chief operating officer of CBPCI Advanced, a Brentwood, Tenn.-based company that helps manage patients’ transition to post-acute care and has participated in the older model. He told Med Page Today that the new bundled-care model, to start in October, is different in important respects from the older one.
For one thing, he told the news service, CMS is, in Med Page’s paraphrase of his remarks, “incentivizing providers to reduce costs by 3 percent for each episode of care, rather than 2 percent as in the old model.”
In addition, “it lasts longer, up to 2023, which we think is a good thing.”
Mr. Paine added that the fact that CMS has fewer episodes of care to choose from may indicate that “of the 48 original [episode types], many of those weren’t being executed on, so probably they just bore down to episodes that actually have real volume.”
“I think BPCI 1.0 has proven to be successful for those participants that have hung in there. On the last go-round, people were sticking their toes in the water, and a lot of people were too nervous to get in — that felt more like a pilot, and this is more of a long-term commitment. Given the success we’ve had in BPCI 1.0 … I think people will participate more in this one, given there’s a game plan in hand.”
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