On Tuesday, January 9, 2018, the Centers for Medicare and Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) announced a new voluntary episode payment model, Bundled Payments for Care Improvement Advanced (BPCI Advanced Model) that will test a new iteration of bundled payments for 32 Clinical Episodes. The Advanced BPCI Model will operate under a retrospective model where the usual fee-for-service (FFS) payments are made, and the total FFS payment for the clinical episode is then retrospectively reconciled against a predetermined target price.
The Model Performance Period for BPCI Advanced starts on October 1, 2018, and runs through December 31, 2023. Participants must apply to this voluntary program. Applications and all required materials must be submitted via the BPCI Advanced Application Portal. The Portal will be open from January 11th to March 12th at 11:59 pm EST. Questions regarding the BPCI Advanced Model can be directed to BPCIAdvanced@cms.hhs.gov.
BPCI Advanced will qualify as an Advanced Alternative Payment Model (Advanced APM) under the Quality Payment Program. CMS has indicated that an eligible clinicians’ participation in will not be tracked, for purposes of the Qualifying APM Participant (QP) determination and the five percent APM Incentive Payment, until the Performance Period beginning on January 1, 2019.