Bundled Payment for Care Improvement

CMS Announces Bundled Payment for Care Improvement Initiative

Last week, the Centers for Medicare & Medicaid Services (CMS) announced the health care
organizations selected to participate in the Bundled Payments for Care Improvement (BPCI) initiative, an
innovative new payment model. Congratulations to Visiting Nurse Service of New York Home Care for
being selected. Under BPCI organizations will enter into payment arrangements that include financial
and performance accountability for episodes of care. These models may lead to higher quality, more
coordinated care at a lower cost to Medicare. According to CMS the research supports bundled
payments can align incentives for providers – hospitals, post-acute care providers, physicians, and other
practitioners– allowing them to work closely together across all specialties and settings.

Model 2 - the episode of care will include the inpatient stay in the acute care hospital and the episode
will end either 30, 60, or 90 days after hospital discharge. Participants can select up to 48 different
clinical condition episodes.

Model 3- the episode of care will be triggered by an acute care hospital stay and will begin at initiation
of post-acute care services with a participating skilled nursing facility, inpatient rehabilitation facility,
long-term care hospital or home health agency. The post-acute care services included in the episode
must begin within 30 days of discharge from the inpatient stay and will end either a minimum of 30, 60,
or 90 days after the initiation of the episode. Participants can select up to 48 different clinical condition
episodes.

For a complete list of New York health care organizations selected to participate in Model 2 and 3, click
here.

Contact: Cheryl Udell. cudell@leadingageny.org, 518-867-8871.