CMS' Bundled Payments for Care Improvement Initiative lets healthcare providers take part in a test of bundled payments' power to drive more coordinated care across various settings. The BPCI initiative involves four different payment models, depending on the type of healthcare providers involved and the nature and time frame for services included in the bundle.
Post-acute care providers can participate in two of the four models: Model 2, in which the episode of care includes the inpatient stay in an acute-care hospital and all related services during the episode, considered to end either a minimum of 30 and up to 90 days after discharge; and model 3, which involves episodes of care that are triggered by an acute-care hospital stay but begin at the initiation of post-acute care services with a participating skilled nursing facility, inpatient rehabilitation facility, long-term care hospital or home health agency.
According to Avalere Health Director Brian Fuller, post-acute care providers participating in the initiative will have the following three strategic advantages:
1. Data access. The BPCI opens the door to historic Medicare claims data for participating providers.
2. Risk-based payment experience. BPCI participants gain familiarity with risk-based reimbursement during the experimentation stage.
3. Market positioning. Providers taking part in the initiative have the opportunity to build relationships with hospitals and physicians, better positioning themselves in their markets.
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