CMS extends bundled payment pilot by 2 years

CMS is extending Bundled Payments for Care Improvement Advanced by two years, and it will now run through Dec. 31, 2025. 

BPCI Advanced tests whether linking payments for an episode of care will "incentive healthcare providers to invest in practice innovation and care redesign to improve care coordination and reduce expenditures while maintaining or improving the quality of care for Medicare beneficiaries," according to an Oct. 13 CMS news release. 

The extension includes new application opportunities, according to the release. CMS said it plans to announce requests for applications in early 2023 for Medicare-enrolled providers and suppliers and Medicare accountable care organizations.  

The program launched in October 2018. As of Dec. 31, 2021, more than 1.2 million Medicare beneficiaries have received care from BCPI Advanced participants.  

CMS is also implementing pricing methodology changes to the program in 2023. Those changes include:

  • Reducing the CMS discount for medical clinical episodes from 3 percent to 2 percent. 
  • Reducing the peer group trend factor adjustment cap for all clinical episodes from 10 percent to 5 percent. 
  • Holding participants accountable for all clinical episodes in which the beneficiary has a COVID-19 diagnosis during the clinical episode.  

Read the full release here

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