CMS extends participation for bundled pay initiative

The Centers for Medicare & Medicaid Services said awardees in the Bundled Payments for Care Improvement initiative can extend their participation for two more years.

Awardees in Models 2, 3 and 4, which began in October 2013, were supposed to end participation at the end of this September. The extension means both those groups and those that joined in 2014 can continue through Sept. 30, 2018.

“Bundling payment for services that patients receive across a single episode of care — such as a heart bypass surgery or a hip replacement — is one way to encourage doctors, hospitals and other healthcare providers to work together to better coordinate care for patients, both when they are in the hospital and after they are discharged,” wrote Patrick Conway, M.D., CMS Acting Principal Deputy Administrator and Chief Medical Officer on Monday. “The initiative is part of the Administration's broader strategy to improve the healthcare system by paying providers for what works, unlocking healthcare data, and finding new ways to coordinate and integrate care to improve quality and reduce costs.

BPCI has 1,522 participants, made up of 321 awardees and 1,201 episode initiators. In Models 2, 3 and 4 there are 48 clinical episodes from which participants can choose when looking at care redesign, savings and improving quality.

Awardees assume financial liability for the clinical episode spending and have signed an agreement with CMS. Episode initiators are providers that trigger BPCI episodes of care and do not bear risk directly, unless they are also an awardee.

One recent study found bundled payments for joint replacements reduced hospital readmissions and decreased discharges to post-acute care facilities.