BPCI Advanced: Key considerations for prospective model participants

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By Devin Cohen, Evander Williams, Michael Lampert, Pamela M. Pelizzari | 10 April 2019
On January 9, 2018, the Centers for Medicare and Medicaid Services (CMS) announced a new voluntary bundled payment model, Bundled Payments for Care Improvement Advanced (BPCI Advanced). The model started on October 1, 2018, and CMS has indicated that there will be an additional opportunity for new entrants to start on January 1, 2020. For organizations interested in pursuing BPCI Advanced, do the potential rewards for participating offset the risks and costs associated with that participation? This paper considers the factors which can influence an organization’s decision to enter BPCI Advanced, and, if appropriate, its decision to share risk with a convening organization.