If you are in a physician group practice and are transitioning from Bundled Payment for Care Improvement Advanced (BPCI) Classic to BPCI Advanced you should be aware that with the transition, many physician group practices are not able to use remainder funds, so physicians can only be reimbursed up to the 50% cap. In BPCI Classic, the physician group practices (PGPs) were allowed to use the savings exceeding 50% to offset direct and indirect costs related to participation in BPCI as well as general overhead of the group.

The financial methodology in BPCI Classic provided the proper financial incentive for the PGP to take risk and incur costs it otherwise would not have, while maintaining the integrity of proper incentives. The current interpretation of the cap is a strong disincentive for PGPs to participate in at-risk APMs such as BPCI-A given substantial investments in staff, IT for analytics and other investments to successfully participate.

» Click here to let your Congressional representatives know that you believe the Centers for Medicare and Medicaid Innovation (CMMI) should reinstate in BPCI Advanced the financial methodology used in BPCI Classic and allow excess funds to flow to any participating PGP to offset overhead and related costs for participating in the new model.