Advanced Bundled Payment Model Reduced Payments for High-Risk Patients
RevCycle Intelligence November 9, 2022
Participation in the BPCI-A helped reduce Medicare payments for high-risk patients and was associated with a $1,412 decrease in costs per episode for frail patients and a $1,045 reduction for patients with multimorbidity.
Hospital participation in Medicare’s Bundled Payment for Care Improvement Advanced Model (BPCI-A) decreased Medicare payments and did not negatively impact health outcomes for high-risk patients, a Health Affairs study found.
CMS launched the BPCI-A in October 2018 as a voluntary Alternative Payment Model (APM) in which hospitals are held accountable for the costs and outcomes of 90-day episodes of care. The model has been associated with reductions in Medicare payments per episode and improved clinical outcomes.
However, hospitals must either decrease utilization or attract a less...