January 17, 2018

CMS Announces Voluntary Bundled Payment Model

On January 9, the Centers for Medicare & Medicaid Services’ (CMS) Innovation Center announced a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced (BPCI Advanced).

Under this bundled payment model, participants can earn additional payment if all expenditures for a beneficiary’s episode of care are less than a spending target that factors in quality. This model will be considered an advanced alternative payment model (APM) under the Quality Payment Program. Details are described in a CMS news release.

CMS has also issued a request for application (RFA) for entities or physician groups to voluntarily apply and participate in any of the 29 inpatient clinical episodes and three outpatient clinical episode categories that will be available for selection. In this very detailed RFA, CMS outlines the application process, participation requirements, participation conditions and other details, but it has yet to disclose the actual 32 episodes that this new APM would include.

The RFA submission period begins on January 11, 2018, and ends on March 12 at 11:59 pm ET. CMS provides for one other subsequent enrollment date of January 1, 2020. The model’s performance period will run from October 1, 2018, to December 31, 2023, with all participation agreements ending by December 31, 2025.