CMS recently announced that the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model will be extended for two years. Initially launched on October 1, 2018, the BPCI Advanced Model, which was set to end on December 31, 2023, will now conclude on December 31, 2025.
Regardless of previous experience, all Physician Group Practices (PGPs) and Acute Care Hospitals (ACHs) will have an opportunity to enroll or start anew.
Request for Applications (RFAs) will be released in early 2023 for Medicare-enrolled providers and suppliers and Medicare Accountable Care Organizations (ACOs) to participate in the Model’s two-year extension (2024–2025).
BPCI Advanced can be a lower-barrier entry point to gaining experience in managing beneficiary cost and quality risk for some organizations. It allows your leaders and physicians to obtain rich, detailed beneficiary claims data on your organization’s historical performance from a CMS bundles standpoint. This same data also helps facilitate strategic decision-making on whether you’re prepared to move forward in a value-based reimbursement environment or can help identify areas of opportunity within your organization and market.
Key Considerations
- Application is non-binding, allowing several months of no-risk analysis
- Participation is voluntary with 90-day termination options
- Window to apply is limited
- Claims data and target prices will be provided after the initial application is submitted
- Applicants would start January 2024 for up to two (2) years
How Forvis Mazars Can Help
Forvis Mazars has successfully helped hundreds of providers navigate BPCI Advanced participation, strategies, and financial opportunities. Many of our clients have capped out on gains and continue to look for new bundled payment opportunities. Our team of experienced consultants is prepared to help you in the following ways:
- Application process (likely an abbreviated window)
- Strategic data analysis to help determine if BPCI Advanced is a good clinical and business decision
- Episode selection
- Program development and structure
- Best practices for care pathways, clinical risk management, discharge protocols, waiver utilization, identification, and development of post-acute network
- Physician engagement and alignment
- Gainsharing development and implementation
- Ongoing monitoring of episodic claims data
For questions or to learn more, reach out to a professional at Forvis Mazars or submit the Contact Us form below.