viernes, 21 de septiembre de 2018

BPCI Advanced Bulletin 09.21.18

Centers for Medicare & Medicaid Services, Center for Medicare & Medicaid Innovation

Bundled Paymetns for Care Improvement Advanced, Center for Medicare & Medicaid Innovation

New CMS Model Launch October 1st

The CMS Innovation Center is excited about the launch of the new BPCI Advanced Model on October 1, 2018.

BPCI Advanced aims to support healthcare providers who invest in practice innovation and care redesign, to better coordinate care, improve quality of care, and reduce expenditures. The Model qualifies as an Advanced Alternative Payment Model (APM). Eligible clinicians who meet threshold levels for participating in BPCI Advanced, will receive a five percent APM Incentive Payment under the Quality Payment Program.

The BPCI Advanced Model 5-year Performance Period will begin on October 1, 2018 and run through December 31, 2023.

MODEL OVERVIEW

Voluntary bundled payment model
Single retrospective payment and risk track
90-day episode period
29 Inpatient Clinical Episodes
3 Outpatient Clinical Episodes
Qualifies as Advanced Alternative Payment Model (Advanced APM)
Payment is tied to performance on quality measures
Preliminary Target Prices provided prospectively, prior to the start of each Model Year

Patient Engagement is Crucial to Success in the Model

The BPCI Advanced team created two Patient Vignettes that illustrate how the patient experience changes within the context of the BPCI Advanced Model versus the traditional Fee-For-Service payment structure.

View the Patient Medical Vignette at: https://downloads.cms.gov/media/innovations/bpciadvanced-vignette1-ffsbp-cardiology.mp4

View the Patient Surgical Vignette at: https://downloads.cms.gov/media/innovations/bpciadvanced-vignette2-ffsbp-surgical.mp4

Bundled Payments Goals is to Improve the Patient Experience

Seamless, streamlined experience

Avoid complications

Reduce readmissions

Achieve better outcomes

Beneficiary Notification Letter

The BPCI Advanced Model Participation Agreement requires that Participants, their Episode Initiators and Participating Providers, provide a Beneficiary Notification Letter to Medicare beneficiaries who meet the eligibility criteria of the Model's Clinical Episodes. CMS will provide a template for this document that may not be modified by Participants, Episode Initiators, or Participating Providers. The purpose of this letter is to educate beneficiaries that they still have all the same Medicare rights and protections, including the right to choose their hospital, doctor, or other health care provider. However, if the beneficiary does not wish to receive care under the BPCI Advanced Model, he or she must choose a health care provider that does not participate in the Model.

Implementation of the Model

Model Year 1: 10/1/18 - 12/31/18*

Model Year 2: 1/1/19 - 12/31/19

Model Year 3: 1/1/20 - 12/31/20

Model Year 4: 1/1/21 - 12/31/21

Model Year 5: 1/1/22 - 12/31/22

Model Year 6: 1/1/23 - 12/31/23

*Note that Model Year 1 is truncated

Next Application Opportunity for Model Year 3 (2020)

CMS will provide an additional opportunity for organizations to apply to participate in the Model during the spring of 2019. This second Cohort will commence participation on January 1, 2020, for Model Year 3. Application materials will be posted on the BPCI Advanced website. At this time, there are no additional application periods planned for Model Years 4 or 5.

We will send a bulletin to all subscribers of the BPCI Advanced listserv with updates on the Model.

Questions?

Contact the BPCI Advanced Team at:

BPCIAdvanced@cms.hhs.gov

Follow the Center for Medicare and Medicaid Innovation (CMMI) on Twitter at: https://twitter.com/CMSinnovates

Follow the CMMI Director Adam Boehler on Twitter at: https://twitter.com/AdamCMMi

September 21, 2018

BPCI Advanced Model

Website Revamp Coming in October!

The new easier-to-navigate website will have three webpages:

1) General Resources

Model Description
Clinical Episodes
List of Participants
FAQs by topic
Quality Measures
Technical Materials
Physician-Focused Materials
Recorded Resources (Webinars, Webcasts, Open Forums)

2) Participant Resources

Portals
Deliverables
List of Authorized SNFs for using the 3-day SNF Waiver (Q4 2018)

3) Applicant Resources

Application Materials for first cohort 2018 (for reference purposes only)
APPLICATIONS NOT BEING ACCEPTED AT THIS TIME

BPCI Advanced Model

QPP Fact Sheet

This document explains how the Qualifying Alternative Payment Model (APM) Participant (QP) determination process in the Quality Payment Program (QPP) will define an attribution-eligible beneficiary in the BPCI Advanced Model. This definition is solely for purposes of making QP determinations under the QPP and does not impact model-specific attribution or payment methodology

BPCI Tool Kit

This resource contains information about the primary and secondary drivers of the Bundled Payment for Care Improvement (BPCI) Initiative, in addition to links to articles, case studies, videos, and other resources on effective implementation strategies.

The Model's primary drivers include: strategic partnerships to promote care coordination and data sharing, efficient and appropriate staffing models, patient identification and risk stratification, effective clinical and financial management, patient and family engagement throughout the care continuum, data driven program management, and continuous quality improvement.

The Tool Kit also contains BPCI Awardee Spotlights which take a deeper dive into high-performing BPCI Initiative Awardees and their successful strategies to enhance quality of care, improve health outcomes, and reduce the cost of care.

This is a valuable resource for organizations commencing participation in the new BPCI Advanced Model.