Briefs & Reports

HMA Can Help You Take Advantage of BPCI Opportunity

The Centers for Medicare and Medicaid Services (CMS) recently announced a limited-time open application period for additional participants to be considered for the Medicare Bundled Payments for Care Improvement (BPCI) initiative. The BPCI is an exciting and innovative opportunity for hospitals, post-acute care providers, and physician group practices to earn upside savings under episodic Medicare payment bundles.

The BPCI open application period is an unexpected opportunity that is unlikely to occur again for three years. Eligible providers must apply for entry by April 18, 2014. Now is your chance to apply to participate in the BPCI program.

CMS provides three BPCI models to choose from:

  • Model 2: Retrospective Acute Care Hospital Plus Post-Acute Care – bundles payment for both inpatient and post-acute care for 30, 60 or 90 days. Providers are paid Medicare fee-for-service throughout the episode. Total payment for the episode is retrospectively reconciled against a predetermined target price.
  • Model 3: Retrospective Post-Acute Care Only – bundles payment for post-acute care only for 30, 60 or 90 days. Providers are paid Medicare fee-for-service throughout the episode. Total payment for the episode is retrospectively reconciled against a predetermined target price.
  • Model 4: Acute Care Hospital Stay Only – bundles payment only for acute inpatient care and related readmissions for 30 days. Participants are paid a prospective bundled payment amount.

CMS encourages Medicare ACOs to participate in BPCI. Participating could yield immediate healthcare cost savings.

HMA’s BPCI Team
Principal Stacy Mitchell and Senior Consultant Mike Fazio are an experienced bundled payments team with expertise in the BPCI program. Stacy and Mike successfully helped clients enter the program for BPCI’s initial launch on January 1, 2014. They are ready to put their experience and expertise to work for you to help you navigate the challenges and opportunities that come with this innovative opportunity.

HMA can help you:

  • Understand all components of the BPCI program and participation requirements.
  • Generate application narrative responses to comply with CMS expectations and regulations.
  • Create care redesign plans that improve quality, patient experience, internal cost savings, and reduce medical spending.
  • Create business relationships and collaborative agreements with other health care providers.
  • Analyze CMS historical episode cost data to determine which of the 48 episodes are best suited for your organization.

To learn more about how HMA can help you take advantage of this BPCI opportunity, please contact Stacy Mitchell (717) 836-7760, smitchell@healthmanagement.com or Mike Fazio (617) 720-7800, mfazio@healthmanagement.com.

In addition to the BPCI Team (see links below), HMA leverages the experience of more than 130 professionals from 15 offices across the country to meet your needs. Our colleagues are the best of the best and have expertise in a variety of arenas, including: health economics, public health policy and administration, health care finance and reimbursement, clinical services and quality improvement, managed care, behavioral health, long-term care and health care information technology.

The HMA BPCI Team
Stacy Mitchell
Mike Fazio