The Centers for Medicare and Medicaid Services (CMS) has announced the first cohort of participants in its new Bundled Payments for Care Improvement Advanced (BPCI Advanced) model. The 1,299 participants, which include 832 acute care hospitals and 715 physician group practices spanning 49 states, Washington, DC, and Puerto Rico, will receive bundled payments for as many as 32 episodes of care as an alternative to fee-for-service payments.

BPCI Advanced was announced in January and builds on the original BPCI Initiative that ended on Sept. 30. The first performance period for the just-announced cohort began Oct. 1 and will run through Dec. 31, 2023. Of the 32 episodes of care, 29 are inpatient and include AMI, cardiac arrhythmia, cardiac defibrillator, cardiac valve, congestive heart failure, coronary artery bypass grafting, pacemaker and percutaneous coronary intervention. Additionally, BPCI Advanced includes three outpatient clinical episodes, including cardiac defibrillator and PCI. Also of note, BPCI Advanced qualifies as an Advanced Payment Model (APM) under the Quality Payment Program, potentially qualifying participating clinicians for incentive payments and exempting them from the Merit-Based Incentive Payment System.

Additional information can be found on CMS' BPCI Advanced website. A second application opportunity is slated for January 2020. Practices considering participation in an APM are encouraged to use ACC's APM Framework as a guide to what cardiovascular professionals should consider when evaluating whether to participate. Learn more at ACC.org/APM.

Keywords: ACC Advocacy, Quality Payment Program, Fee-for-Service Plans, Centers for Medicare and Medicaid Services, U.S., Outpatients, Inpatients, Episode of Care, Medicare, Medicaid, Health Expenditures, Group Practice, Coronary Artery Bypass, Percutaneous Coronary Intervention, Heart Valves, Pacemaker, Artificial, Arrhythmias, Cardiac, Heart Failure, Defibrillators, Cohort Studies

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