The American Hospital Association is urging CMS to provide additional information and delay implementation of a new voluntary bundled payment model.
The Bundled Payments for Care Improvement Advanced Model, announced on Jan. 9, will initially include 32 clinical episodes, and will qualify as an advanced alternative payment model under the Medicare Access and CHIP Reauthorization Act's Quality Payment Program. The application deadline for providers is March 12.
In a Feb. 12 letter to CMS Administrator Seema Verma, AHA requested CMS provide detailed programmatic information about the model by March 1, and change the application deadline to April 16.
The AHA's specific recommendations to CMS include:
- Provide target price specifications beyond the first two model years
- Consider using either national or regional historical episode payments — whichever is higher — for target price adjustment
- Allow non-Medicare enrolled conveners to participate in BCPI Advanced without downside risk
- Ensure providers participating in the model "have maximum flexibility to identify and place beneficiaries in the clinical setting that best serves their short- and long-term recovery goals"
- Provide additional information on the composite quality score adjustment used to help determine payment under the model
- Ensure the model includes "sociodemographic adjustment to the readmission, complication and mortality measures"
- Reconsider not allowing the model to qualify as an alternative payment model under MACRA's Merit-based Incentive Payment System
"The changes we recommend … would help facilitate hospitals' participation in and success under the BPCI Advanced model with regard to providing quality care to Medicare beneficiaries and achieving savings for the Medicare program," wrote the AHA.
Read the full letter here.
More articles on healthcare finance:
Donations to USC medical school fall 55% after dean, faculty scandals
U of Texas Health renames cancer center after donors of $25M gift
10 recent hospital, health system outlook and credit rating actions