BPCI Advanced Episode Selection

November 22, 2019


Financial success in BPCI Advanced depends on outperforming risk-adjusted historical data for specific episodes.

With 35 clinical episode types, each with a variety of characteristics, participants need to choose wisely. Take these four key steps toward success.

First, identify clinical champion you can depend on to stay actively involved in the care redesign process. Care teams will need to overhaul the way they deliver patient care–getting them involved early may mean the difference between success and failure.

Make sure you have enough episodes of whichever type you select–the more you have, the better the opportunity to generate enough savings to cover the investment of redesigning care.

Post-acute care utilization and readmission rates can help identify opportunities presented by an episode.  Understanding these opportunities is key for evaluating what investments are needed, which stakeholders to involve, and what might change.

You’ll need to determine the effect CMS’ targets have on each episode type. Comparing your baseline episode experience to the preliminary targets will identify your potential financial savings.

BPCI Advanced presents a great opportunity for practices to gain care management experience and participate in an alternative payment model. Crunch the numbers now—the program’s start date will be here before we know it.

To learn what you can do to prepare yourself to succeed, reach out to DataGen today.