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Policy & Regulation News

CMS Postpones Deadlines for New Bundled Payments Model

Bundled Payments for Care Improvement (BPCI) Advanced applicants now have until Aug. 8 to submit signed participation agreements and select care episodes.

Bundled Payments for Care Improvement (BPCI) Advanced

Source: Thinkstock

By Jacqueline LaPointe

- Participants in the Bundled Payments for Care Improvement (BPCI) Advanced model will have another week to return their signed participation agreements and select clinical episodes.

CMS delayed the deadline for returning the BPCI Advanced information by one week. Participants now have until Aug. 8, 2018, to submit signed participation agreements and clinical episode selections to the federal agency, according to an Innovation Center’s new model timeline.

The new bundled payments model is slated to launch this October. The BPCI Advanced builds on the original BCPI initiative, which has paid participating providers a single, fixed payment for care episodes since 2015.

The BPCI Advanced sets itself apart from the original iteration of the bundled payment models by increasing the level of financial risk providers can assume, qualifying the model as an Advanced Alternative Payment Model (APM) under MACRA.

Unlike its predecessor, the new bundled payments model also will include three outpatient clinical episodes.

Hospitals and physician groups applied to join the BPCI Advanced earlier this year. After returning their documents and care episode selections to CMS in August, participants should expect to submit their deliverables to CMS by Sept. 14, 2018.

CMS plans to announce participant selections by Sept. 2018 and the program will launch a month later.

But industry groups are uncertain if an October 2018 start date will encourage participation in the new bundled payment models. The American Hospital Association (AHA) recently urged CMS to offer two additional start date options for the BPCI Advanced model in 2019.

On top of the October 2018 launch date, the group also called for Jan. 1 and April 1 start dates in 2019 to allow more providers to apply to the bundled payments model.

“These additional start dates would expand the opportunities for applicants to be part of the initial BPCI Advanced cohorts, enabling CMS to pilot the program with a greater number of well-informed participants,” AHA wrote. “Further, by making these start dates optional, CMS can still allow applicants who feel ready to begin by the original program start date of Oct. 1, 2018 to do so.”

The industry group pushed for additional start dates for the BPCI Advanced after providers who applied to join the model failed to receive data on episode target prices and claims data in a timely manner. CMS had promised the information by May 2018, but many providers told the AHA in June that they had never received it.

The updated model timeline from the Innovation Center confirmed the delay, stating that CMS distributed data and target prices to applicants in June 2018. The federal agency also handed out participation agreements for review in July 2018.

The delay in information sharing left applicants with less than two months to analyze the data before the original Aug. 1 deadline for submitting signed participation agreements.

“For hospitals, particularly large hospitals and health systems that operate several facilities and/or in multiple markets, this truncated timeline makes it nearly impossible to make an informed decision about participation in BPCI Advanced, and may lead them to forgo participation altogether,” AHA explained.

CMS has not offered additional start dates for the BPCI Advanced, but the federal agency has been open to postponing deadlines for document submission. The extra week will allow providers to analyze episode target prices and claims data to determine if they truly want to participate in the new bundled payments model.

Providers looking to join the BPCI Advanced in 2019 will have to wait until spring 2019 to apply. The second cohort of the bundled payments model will start on Jan. 1, 2020.

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