Get a Medicare Bonus With New Bundled Payment Model
By David Doolittle

Bundled story photoHave you been sitting around waiting for a new advanced APM under MACRA’s QPP?

More likely, are you constantly looking for ways to redesign and improve how your practice cares for patients?

Do you try to decrease costs by eliminating unnecessary care or care that provides little benefit to your patients?

Are you interested in keeping Medicare expenditures within a specific budget while maintaining or even improving performance on specific quality measures?

Are you still reading these questions?

Even if you answered yes to only two of those questions (even the last one), I’ve got some news you might be interested in: The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) has launched a voluntary bundled payment model that would give participants a Medicare bonus if expenditures remain under a spending target that factors in quality.

Participants in the Bundled Payments for Care Improvement Advanced (BPCI Advanced) plan “may receive payments for performance on 32 different clinical episodes, such as major joint replacement of the lower extremity (inpatient) and percutaneous coronary intervention (inpatient or outpatient),” CMS said in announcing the model.

The model performance period for BPCI Advanced will run from Oct. 1, 2018, to Dec. 31, 2023.

Advanced alternative payment models (APMs) are one of two ways physicians are paid in Medicare under the Medicare Access and CHIP Reauthorization Act’s (MACRA’s) Quality Payment Program (QPP). Under advanced APMs, physicians and providers take on financial risk to earn the advanced APM incentive payment. Under the other track ― the Merit-Based Incentive Payment System ― physicians and other clinicians have to report a range of performance metrics and then have their payment amount adjusted based on their performance.

More information about BPCI Advanced, as well as its requirements, the application template, and the necessary attachments, can be found on the CMS website.

The CMS Innovation Center is planning a Q&A Open Forum from 11 am to noon CT on Tuesday, Jan. 30, 2018. Register for that forum here

And if you still have questions, turn to TMA’s MACRA Resource Center for more MACRA info than you can handle.



Last Updated On

April 19, 2018

Originally Published On

January 11, 2018

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David Doolittle


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Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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