Q: The new federal Bundled Payments for Care Improvement Advanced program precludes long-term care post-acute care providers [LTPACs] from owning the bundles. What should we know?
A: LTPACs represented a large contingent of episode initiators in the BPCI program and achieved a great deal of success. That’s the biggest surprise and it’s been a disappointment, frankly.
Q: Are there any upsides for these providers?
A: Details are forthcoming. That said, there are opportunities for LTPACs to work with episode initiators like participating hospitals that want to design care around bundles to include the critical role that LTPACs play.
Q: What should providers do now?
A: LTPACs should understand how eligible providers are incentivized in the program because there will be a need for preferred provider networks. It’s in their best interests to understand and monitor the program and take advantage of significant cost reduction opportunities in the 90 days after discharge. CMS has said they will continue to make adjustments to the program through a rapid feedback cycle, so BPCI-Advanced is not set in stone. LTPACs should weigh in with CMS on the success they’ve have had in BPCI.