Bundled Payments for Care Improvement Initiative (BPCI) Models 2-4

Year 6 Evaluation and Monitoring Annual Report Key Takeaways:

Consistent with previous reports, the Bundled Payments for Care Improvement (BPCI) initiative independent evaluation found that BPCI resulted in reduced Medicare FFS payments for the majority of clinical episodes evaluated while maintaining the quality of care for Medicare beneficiaries. A new analysis found that the approach to reducing Fee for Service payments differed by provider type for surgical and medical clinical episodes. Despite these encouraging results, Medicare experienced net losses under BPCI after taking into account reconciliation payments to participants, as in previous reports. Technical implementation issues, including the specification of appropriate target prices, may have contributed to these net losses. When BPCI ended, CMS began a new episode - based Advanced Alternative Payment Model, BPCI Advanced, which addresses some of the challenges of the original BPCI model. It remains to be seen whether BPCI Advanced will achieve net savings for Medicare.

Bundled Payments for Care Improvement Initiative (BPCI) Models 2-4 - Year 6 Evaluation and Monitoring Annual Findings-At-A-Glance Report

The Two Page Overview:

Findings-At-A-Glance (PDF)

The Report (includes an Executive Summary):

Year 6 Evaluation and Monitoring Annual Report (PDF)
Go directly to the Executive Summary (PDF)

Additional Supporting Materials:

Appendices (PDF) - Methods discussion, supporting tables, and impact estimates for payment, utilization, and quality measures broken down by clinical episode and initiator type
Model Page: Bundled Payments for Care Improvement (BPCI) Initiative: General Information