Industry Insights

Guidance for Healthcare Providers and Purchasers

Leading healthcare data analytics insights:

Keeping Your BPCI Advanced Participation Options Open

Submitted by jonpearce on Thu, 2018-02-15 15:30

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:

Why Many Hospitals Left CJR

Submitted by jonpearce on Sun, 2018-02-11 07:50

CMS recently released an updated "frequently asked questions" document for the Comprehensive Care for Joint Replacement (CJR) program. Of interest in that FAQ was statistics regarding the number of hospitals currently participating in CJR. As most followers of mobile payment programs are aware, CMS reclassified 33 of the 67 formerly-mandatory Metropolitan statistical areas (MSAs) to be voluntary, allowing hospitals in those MSAs to cease participation in the CJR program.

Questions Remain about BPCI Advanced Targets

Submitted by jonpearce on Wed, 2018-02-07 08:53

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.