BPCI Advanced

Choosing BPCI Advanced Episodes for the August 1 Deadline

Submitted by jonpearce on Sun, 2018-07-15 19:40

CMS provided BPCI Advanced applicants with an unexpected gift in early July when they announced a "no harm, no foul" bailout opportunity for all participants occurring in March 2019. At that point, participants can retroactively terminate participation in any or all BPCI Advanced episodes, with no financial risk. This gives participants an additional eight months past the August 1 application deadline to evaluate opportunities in various selected episodes.

Evaluating BPCI Advanced Target Factors in Episode Selection

Submitted by jonpearce on Sun, 2018-07-08 19:49

Along with the BPCI Advanced claims data, CMS provided to applicants with an Excel workbook named 2018_05_31_bpid-0000_Baseline_MY_1_2_Prelim_TP.xlsx containing the preliminary targets for all episode types in which the hospital had sufficient baseline episode volume. Those workbooks also contained the three factors that are used to adjust each hospital's baseline cost to compute the final target amount.

BPCI Advanced Data Will Be Limited

Submitted by jonpearce on Fri, 2018-05-11 07:31

When we heard that CMS has selected a new data contractor for the BPCI Advanced program, we remain optimistic about the quality of the data that we would receive for this program. Data for the BPCI and CJR programs was relatively complete, containing demographic information about patients (name, medical record number, zip code, etc.), payment components (DRG outlier payments, IMD, DSH, etc.), and other fields describing utilization levels.

Combining Episodes Creates New Opportunities in BPCI Advanced

Submitted by jonpearce on Thu, 2018-05-10 16:23

In the BPCI program many hospitals and physicians selected individual episode families in which to participate. Providers participated in major joint replacement, congestive heart failure, simple pneumonia, and other similar types of episodes that have sufficient volume to create statistical stability and sufficient return on the care management investment.