On February 14, 2014, the Centers for Medicare & Medicaid Services (CMS) announced that it is accepting requests for consideration to participate in Phase 2 for Models 2, 3 and 4 of the Bundled Payments for Care Improvement (BPCI) Initiative. The BPCI Initiative is intended to encourage coordination of care in order to improve care while reducing costs, and allows participants to choose from 48 episodes of care, each of which involves care linked to an acute care hospital inpatient stay for one of certain Medicare Severity Diagnosis Related Groups (MS-DRGs).
Model 2 provides retrospective bundled payments to hospitals, physicians and post-acute providers for an episode of care consisting of an inpatient hospital stay followed by post-acute care. Model 3 involves retrospective bundled payments for post-acute care for
an episode that does not include the inpatient hospital stay. Participants can select varying lengths of time for an episode varying levels of risk. Participants in these retrospective models receive discounted Medicare fee-for-service payments. If total payments for an episode are less than the target price the participant will share in the savings.
Participants in Model 4 receive a prospective bundled payment for an acute inpatient hospital stay and related readmissions. Organizations that wish to participate in more than one model need to submit a separate intake forms for each model.
This open period is for participation as an Awardee (which participates by itself and bears risk), as an Awardee Convenor (which coordinates the BPCI participation of multiple health care providers, referred to as Episode Initiators, and accepts risk under the
model), or as a Facilitator Convenor (which does not accept risk but coordinates participation of multiple health care providers, known as Designated Awardees or Designated Awardee Conveners, that accept risk). Current BPCI participants that wish to add new episodes of care or new Episode Initiators, as well as new participants, are allowed to submit intake forms during this open period.
The submission deadline is April 18, 2014. The Notice is available at https://www.federalregister.gov/articles/2014/02/14/2014-03311/medicare-program-bundled-payments-for-care-improvement-models-2-3-and-4-2014-winter-open-period. Intake forms and information are available at http://innovation.cms.gov/initiatives/Bundled-Payments/Models2-4OpenPeriod.html