Findings Have Implications for Current and Prospective BPCI-A Participants
ANN ARBOR, MICH., / MAY 23, 2019 — The Centers for Medicare and Medicaid Services is accepting applications for the next cohort in its Bundled Payments for Care Improvement Advanced Model now through June 24. As prospective and current participants prepare to apply and participate in Model Year 3, they should understand the positive or negative effect BPCI-A target price methodology could have on their program results from day one.
CMS designed the program to encourage broad participation with the intention to reward improvement over time. Although CMS understandably relies on a hospital’s past performance to set target prices, it does not consider how two key factors affect a hospital’s true performance in a given episode: (1) Variability from limited sample sizes and (2) Hospital-specific trends through and beyond the target performance period.