News & Events

DataGen launches new BPCI Advanced tools to map changes in episode participation

DATE: 06/04/2020

Interactive tools show changes across clinical episode categories and geography, giving provider organizations insight into how the program is maturing

DataGen, a leading healthcare data analytics and policy firm, has launched two free online tools to give provider organizations insight into national and regional episode participation trends in the Bundled Payments for Care Improvement Advanced program. The interactive tools map shifting BPCI-A episode participation from model years 1 and 2 to model year 3 by clinical episode category and by geography.

DataGen designed the tools to give provider organizations a clearer picture of where their current participation in BPCI-A stands in relation to national and regional trends. Using the first tool, users can select a clinical episode category and easily compare data from model years 1 and 2 with model year 3. The second tool enables users to enter their city or ZIP code to view data from their Core-based Statistical Area. These regional data show changes in total participants and number of selected clinical episode categories from model years 1 and 2 to model year 3, as well as changes in the top three clinical episode categories.

DataGen released an interactive BPCI-A map last year that gave provider organizations visibility into average expenditures at the local and national levels, helping them better assess whether they can be successful under BPCI-A.

“We are seeing more participation in BPCI-A model year 3 overall,” said Alyssa Dahl, DataGen’s director of informatics. “With the second enrollment period offered last year, providers who felt unprepared at the onset of model year 1 were likely able to take some more time to get executive buy-in and make the operational improvements needed internally for a model year 3 entry.”

“Many of our clients are approaching BPCI-A as a good way for them to ‘get their feet wet’ in bundled payment programs and start transforming care in anticipation of future mandatory models,” said Mike Ilnicki, DataGen’s president. “We hope our interactive online tools will help current and future program participants see more of the big picture around how BPCI-A participation has evolved and where they would fit into episode participation trends.”

The Centers for Medicare and 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 35 clinical episodes during the application period (31 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. The second cohort applied for the program in 2019 and began their participation on Jan. 1, 2020.