Geisinger, Dignity Health among 1,300 providers to sign up for CMS’ bundled payment model
Nearly 1,300 providers—including Adventist Health, Dignity Health, Geisinger Health System and Sutter Health—have signed up to participate in the first wave of CMS’ new voluntary bundled payment program.
The Centers for Medicare & Medicaid Services unveiled the new bundles in January, making it the first new advanced alternative payment model launched under the Trump administration.
CMS announced Tuesday that 1,299 providers signed on to its Bundled Payment for Care Improvement (BPCI) Advanced program. This includes 832 acute care hospitals and 715 physician group practices across 49 states, the District of Columbia and Puerto Rico. “To accelerate the value-based transformation of America’s health system, we must offer a range of new payment models so providers can choose the approach that works best for them,” CMS Administrator Seema Verma said.
“We look forward to launching additional models that provide an off-ramp to the inefficient fee-for-service system and improve quality and reduce costs for our beneficiaries,” she added.
The program began on Oct. 1 and will run through Dec. 31, 2023. The original version of BPCI ended on Sept. 30. CMS’ updated version of the model includes bundled payments for new episodes of care such as outpatient services, and the agency will provide target prices in the model before the start of each year of the program to allow providers to plan more easily.
Michael Abrams, managing partner of Numerof & Associates, told FierceHealthcare that one other new element may be particularly appealing: The model exempts participating providers from reporting requirements under the Medicare Access and CHIP Reauthorization Act (MACRA), as it is an APM that would exempt them from the Merit-Based Incentive Payment System (MIPS).
“Getting that monkey off of their back, I think, is very attractive,” Abrams said.
The program includes 32 episodes of care in total—29 inpatient and 3 outpatient—with the most popular with participants being lower extremity joint replacements, congestive heart failure and sepsis, CMS said. The simplicity and flexibility, Abrams said, is also going to draw hesitant providers into the program.
Despite those perks, Abrams said he doesn’t think that the modifications made in this version of bundles is driving interest. Instead, he said providers are growing wise to the fact that they need to evolve to stay alive.
CMS has made it clear that it intends to replace the fee-for-service model, and new entrants to the system—such as joint venture between Amazon, Berkshire Hathaway and JPMorgan Chase—could steal away a significant portion of their market share.
“The move to payment models like this one, that require accountability for cost and quality, has gotten off to a fairly slow start,” Abrams said, “but we could be approaching a tipping point, at which competitive pressure for a more responsive approach to patients becomes a de facto requirement for continuing to do business in the healthcare space.”
CMS unveiled BPCI Advanced shortly after it announced that it would cancel two mandatory bundles planned by the Obama administration. Those programs, which were for cardiac and joint replacement care episodes, were set to begin in January.
The mandatory bundles had been delayed twice under former Department of Health and Human Services Secretary Tom Price, who was a vocal critic of the programs as a congressman.
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