Archive

ICYMI: Notes from the field for June 2019

June saw several big conferences for our world — and also saw some interesting policy updates and decisions on key programs. Take a look below to learn more and let us know what caught your attention last month.   Social barriers to health America’s Health Insurance Plans held its annual meeting in June and announced […]

Making the Most of MSPB

You may not know about MSPB, but focusing efforts there can lead to real savings Now that bundled payment programs like the Oncology Care Model (OCM) and the Comprehensive Care for Joint Replacement (CJR) model have been in effect for some time, one factor is becoming clear: hospitals appear reluctant to participate. As of July […]

Understanding the BPCI Advanced Targets

In February, CMS issued preliminary target specifications for the Bundled Payments for Care Improvement (BCPI) Advanced program.  The targets in CMS bundled payment programs have progressed from straightforward, provider-specific, historical performance-based targets in original BPCI, to regional historical targets stratified by patient diagnosis in the Comprehensive Care for Joint Replacement (CJR) program, to case mix-adjusted, […]

10 Things to Know About the New BPCI Advanced Program

What you should be aware of—and what you can do now   After months of waiting, the Centers for Medicare and Medicaid Services (CMS) released its new voluntary episode model, Bundled Payments for Care Improvement Advanced (BPCI Advanced), which begins October 1, 2018. DataGen’s policy analysts are currently assessing the model as a whole. Participants—both […]

How to Use Benchmarks in BPCI and CJR

The use of benchmark cost comparisons is common throughout healthcare. Benchmarks are used for comparisons of internal hospital costs across hospitals, for utilization rates in Accountable Care Organizations, and in many other places. The concept of the benchmark is that the hospitals whose costs or utilization are close to or below the benchmark will experience […]

Who Should Own Bundled Payment Episodes?

With the announcement of the next generation of Medicare bundled payment programs (“BPCI Advanced”) expected at any time, many different organizations are offering opinions about how this program will be structured and which types of providers should participate in which type of episodes. A frequent topic in this conversation is the “ownership” of the episodes; […]

Three Questions for BPCI Advanced

The Programmatic Answers to Look for in the BPCI Advanced Announcement Many current and potential bundled payment participants are eagerly awaiting the announcement from CMS of the “BPCI Advanced” program. CMS has planned this program for many months, but announcement of the details has apparently been stalled somewhere within the government. Many current Bundled Payments […]

A Year into OCM: Four Essential Practice Redesign Activities

The first 12 months of the Center for Medicare and Medicaid Innovation’s Oncology Care Model (OCM) have been a significant learning experience for participants. Practices have had to come to grips with how different OCM is from other bundled payment models like the Comprehensive Care for Joint Replacement (CJR) or Bundled Payments for Care Improvement […]