Single Tracks Blog Archive

Keeping Your BPCI Advanced Participation Options Open

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Hospitals interested in applying for the BPCI Advanced program should note that there are several options for their participation. However, participants will be limited only to options for which they submit applications by March 12, 2018. Therefore, to keep their options open hospitals must submit applications for any alternative structure that they later may wish to adopt.

The alternatives for hospitals are:

Questions Remain about BPCI Advanced Targets

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In the two current Medicare bundled payment programs, three different methodologies have been used to establish payment targets. In the BPCI program targets are based on each participant’s historical episode cost, with “cost” defined as all payments made by Medicare or beneficiaries for services provided to the beneficiary during the episode. In this program participants will achieve financial success by reducing episode costs below their historical levels.

CMS Inaction on Outpatient Major Joint Replacement Threatens CJR and BPCI Advanced Participation

Bundled payment episodes for major joint replacement (MJR) have been among the most successful "experiments" into the BPCI and CJR programs. Most BPCI participants in MJR episodes have been effective in reducing post-acute institutional utilization, and have achieved significant cost savings in these episodes. Among our clients participating in the CJR program, about 35% achieved savings that exceeded the stop gain limits; another 25% achieved savings that did not exceed the stop gain limits, and only 25% had losses.

What Specialists Should Consider in Bundled Payment Participation

by Jonathan Pearce, CPA, FHFMA and Darcie Hurteau

Comments by HHS Secretary-Designate May Portend More Mandatory Bundles

by Jonathan W. Pearce, CPA, FHFMA

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