BPCI is a voluntary program in which healthcare providers accept clinical and financial risk for patients over specified blocks of time. Under the program, providers can select episodes to test from a group of 48 clinical conditions, including procedures (such as joint replacements) and medical conditions (such as sepsis).
“Strong participation in a voluntary program shows providers’ willingness to test new alternative payment models,” said Josh Seidman, senior vice president at Avalere. “However, the fact that many providers that entered the program decided it’s not currently in their financial interest to accept downside risk may cause CMS to consider additional mandatory programs in the future.”
Among the 10 conditions most commonly tested by BPCI participants, three are related to infections. They are:
- Simple pneumonia and respiratory infections — No. 2
- Sepsis — No. 6
- Urinary tract infections — No. 7
To access Avalere’s full report on BPCI participation, click here.
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