Getting Ready for Bundled Payments: On Your Mark. Get Set. Go.

By Dr. Mansoor Khan, CEO, Persivia
Twitter: @PersiviaInc

So you have decided to join the bundled payments train, now what?

CMS has not yet announced the dates for when the application period will start and what the other associated dates will be. But we do know that the start date for the next BPCI Advanced program will be Jan 1, 2020. If we assume that the application process will follow the same timeline as 2018, we can expect the application portal to be open in late March or early April.

There are a number of things that you do right now that will help you be ready to apply for, launch, and successfully manage your BPCI-A program.

Required activities can be grouped into two categories: what you need to do to prepare to apply, and what are the tasks you’ll need to accomplish to successfully run your BPCI-A program.

Figure 1, below, lists both the high-level activities that will need to be performed as well as the recommended order and duration of each activity.

Success in running BPCI Advanced is predicated on implementing certain activities that have been shown to be effective in over 5 years of bundled payment programs. These are:

  1. Data-driven program management
  2. Strategic partnerships to promote care coordination and data sharing
  3. Efficient and appropriate staffing models
  4. Patient identification and risk stratification
  5. Effective clinical management
  6. Effective financial management
  7. Patient and family engagement
  8. Continuous quality improvement

All of these require a technology infrastructure that will support care management, care coordination among all participants in the Episode, and tracking and analysis of financial outcomes.

We’ll explore the details of each of these areas in upcoming posts. Thanks for reading.

This article was originally published on the Persivia Blog and is republished here with permission.