Refinements to the BPCI Initiative Models

CMS intends to implement a new voluntary bundled payment model for CY 2018, based upon BPCI, where the model(s) would be designed to meet the criteria to be an Advanced APM. The BPCI initiative Models 2, 3, and 4 would not currently qualify as Advanced APMs based on the two of the Advanced APM criteria: payment based on quality measures and CEHRT use. Specifically, BPCI participants are not currently required to use CEHRT, and although CMS examines the quality of episode care in the BPCI evaluation, BPCI episode payments are not specifically tied to quality performance. Instead, BPCI episode payments are based solely on episode spending performance, although we expect that reductions in spending would generally be linked to improved quality through reductions in hospital readmissions and complications. Read the CMS rule.