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Bundled payment participants face choices on 2020 performance measurement, continued participation

By: Rich Daly

DataGen was recently featured on

  • Current BPCI-A participants will need to decide this fall whether to stay in the program for 2021.
  • Some participants’ results worsened in the second year, according to newly released data.
  • Decisions on remaining in the program should take into account new options from CMS.

Provider participants in Medicare’s largest bundled payment program must decide not only whether to remain in the program but also whether to use new COVID-19-related flexibilities in performance measurement.

The more than 1,000 hospitals and physician group practices that remain in the Bundled Payments for Care Improvement Advanced (BPCI-A) voluntary model face some tough decisions this year, with Medicare offering new options in response to the pandemic. Those options came amid massive disruptions in elective episodes and procedures after many hospitals ceased to offer them during much of the pandemic either voluntarily or in response to government mandates.

“For institutions, they’re evaluating whether or not to even stay in the program for [2021] because of the uncertainty and the financial risk,” said John Kalamaras, business intelligence analytics manager at DataGen. “So, they have to judge how they are doing now and if they are going to continue on in the program.”

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