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Welcome to Toward Accountable Payment, the official blog of the Medicare Payment Innovation Project. The project is an ongoing initiative to study provider payment reform and support organizations engaging in innovative payment programs.
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Yesterday, the Center for Medicare and Medicaid Innovation (CMMI) announced two significant changes to its largest accountable payment program, the Bundled Payments for Care Improvement (BPCI) initiative. There are currently more than 450 providers slated to participate in the program, which reimburses entire episodes of care—in some cases including all related physician services, readmissions, and post-acute care—at a single rate.
BPCI update: Three-month delay, fewer metrics to report
Rob Lazerow and Jordan Stone
In our initial analysis of the clinical conditions selected by BPCI participants, we were surprised to find that nearly half of selected conditions were medical rather than surgical. This was a clear departure from earlier Medicare and private sector bundling programs, which focused almost exclusively on surgical care.
Although BPCI includes a near even split of medical versus surgical care as a whole, this trend is heavily influenced by the 165 post-acute care providers participating in Model 3. In fact, we find very different participation trends when we narrow our focus to acute care providers, the organizations selected to participate in Models 2 and 4.
Are Medicare bundling programs embracing—or avoiding—medical conditions?
Last month, the Center for Medicare and Medicaid Innovation (CMMI) announced that more than 450 hospitals and post-acute providers were selected for the Bundled Payments for Care Improvement (BPCI) initiative. Participating providers will be reimbursed through single case rates for select episodes of care, combining payment for a variety of related hospital, physician, and post-acute services.
Although the BPCI initiative just launched in February, it already includes more participants than CMS’s two flagship accountable payment programs, the Medicare Shared Savings Program (MSSP) and Pioneer ACO Model. BPCI includes a diverse collection of providers with facilities in 44 states, contracting for nearly 9,000 combined medical and surgical bundles across inpatient and post-acute settings.
Putting CMMI's newest (and biggest) program on the map