Lower Clinical Spending Needed in BPCI-A Program to Avoid Losses – RevCycleIntelligence.com

RevCycle Intelligence April 18, 2023
By Victoria Bailey

BPCI-A participants would’ve had to reduce clinical spending by around 3.8 percent in the first two performance periods for CMS to avoid financial losses, but they only reduced spending by 0.53 percent.

Hospitals and physician groups participating in the Bundled Payments for Care Improvement Advanced (BPCI-A) program would have had to reduce clinical spending by 3.7 percent to 8.2 percent during the first four performance periods for CMS to break even, a study published in JAMA found.

BPCI-A program participants select inpatient and outpatient groups of care episodes that last from the day of the encounter to 90 days after discharge. Participants receive a target price for episode spending for each bundle.

Participants receive positive reconciliation payments or bonuses if...

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