News & Events


DataGen Launches BPCI-A Market Evaluation Tool

DATE: 09/19/2019

Providers can explore average expenditures in their market and assess their BPCI-A success

DataGen, a leading healthcare data analytics and policy firm, has launched a free online tool to help hospitals prepare for participation in the Bundled Payments for Care Initiative Advanced program. The new tool gives hospitals visibility into average expenditures at the local and national levels, helping them better assess whether or not they can be successful under BPCI-A.

DataGen’s online market evaluation tool provides visibility into average expenditures for different clinical episode categories in local markets across the country. User hospitals can enter their city or zip code and choose the specific clinical episode category they would like to examine. An interactive map will show regional or national average expenditures for that category. Providers can also download a customized report with tips, strategies and a breakdown of all average expenditures for a given area.

“Success in BPCI-A is going to be founded on how well providers can gain an understanding of their own expenditures as well as market averages,” said Mike Ilnicki, DataGen’s president. “But that data is complex and difficult to navigate. We built this free online tool to help providers make their assessment more easily. We hope it will also help providers choose the right episode types and build internal buy-in that nurtures an organizational culture supportive of the program demands.”

The Centers for Medicare & Medicaid Services announced BPCI-A as a voluntary episode-based bundled payment model in January 2018; it is set to run until the end of 2023. Broadly, the program is an opportunity for providers to ease into value-based care through practice transformation and visibility into data they would not otherwise have access to. Participating providers can choose from 37 clinical episodes during the application period (33 inpatient and four outpatient). Payments are based on individual practice performance compared to risk-adjusted target prices during a 90-day episode of care that continues after discharge or the outpatient procedure.

The first cohort of BPCI-A participants started the program Oct. 1, 2018. This year, the second cohort applied to participate in the program and will begin their participation on Jan. 1, 2020.