Here’s what you should know:
1. Participants in the advanced alternative payment model can earn additional payments if all expenditures are under a spending target that is quality based.
2. Participants can receive payment for 32 different clinical episodes in both inpatient and outpatient care.
3. According to a CMS release, “An episode model such as BPCI Advanced supports healthcare providers who invest in practice innovation and care redesign to improve quality and reduce expenditures.”
4. This is the Trump administration’s first advanced APM, CMS Administrator Seema Verma said. She added, “BPCI Advanced builds on the earlier success of bundled payment models and is an important step in the move away from fee-for-service and towards paying for value. Under this model, providers will have an incentive to deliver efficient, high-quality care.”
5. Under BPCI Advanced, participants will have to redesign care delivery to restrain Medicare expenditures into a defined budget, while also improving on or maintaining performance on specific quality measures. The participants are also required to use certified EHR technology.
6. The model will start Oct. 1 and run through Dec. 31, 2023. For more information, click here.
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