Bpci Advanced Participation Agreement
The BPCI Advanced Participation Agreement: What You Need to Know
If you work in healthcare, you’ve probably heard of the BPCI Advanced participation agreement. But what exactly is it, and what does it mean for your organization?
BPCI (Bundled Payments for Care Improvement) Advanced is a value-based care program from the Centers for Medicare and Medicaid Services (CMS). The program aims to improve care quality and coordination while lowering costs for Medicare beneficiaries. BPCI Advanced is the successor to the original BPCI program, which ran from 2013 to 2018.
To participate in BPCI Advanced, providers must sign a participation agreement with CMS. The agreement outlines the terms and conditions of the program, including payment arrangements, performance measures, and data sharing requirements.
Here are some key things to know about the BPCI Advanced participation agreement:
1. Payment arrangements: In BPCI Advanced, participants are responsible for the cost of care for a defined set of clinical episodes. CMS pays a target price for each episode, and participants are eligible for additional payments if they meet or exceed certain quality and cost targets. The participation agreement outlines the specific payment arrangements for each clinical episode.
2. Performance measures: To earn additional payments, participants must meet or exceed performance targets on several quality and cost measures. The participation agreement specifies the measures and the targets for each clinical episode.
3. Data sharing: Participants are required to share data with CMS and other BPCI Advanced participants. This includes claims data, clinical data, and other information related to the clinical episodes. Participants must also allow CMS and its contractors to access their electronic health records and other relevant systems.
4. Termination: Participants can terminate their participation in BPCI Advanced at any time, with certain conditions. For example, if a participant terminates within the first two years of the program, they may be subject to financial penalties. The participation agreement outlines the conditions and consequences of termination.
5. Other requirements: The participation agreement includes other requirements, such as compliance with applicable laws and regulations, the use of certified EHR technology, and reporting of certain data to CMS.
Overall, the BPCI Advanced participation agreement is a complex document that outlines the terms and conditions of participation in the program. Providers considering participation in BPCI Advanced should carefully review the agreement and ensure they understand the requirements and implications of participation.
As healthcare continues to move toward value-based care, programs like BPCI Advanced will likely become more common. By understanding the participation agreement and other program requirements, providers can position themselves for success in this new era of healthcare.