CMS Announces Bundled Payments Care Improvement Model

Contributed by Michael A. Cassidy

On January 11, 2018, CMS announced a new voluntary episode payment model (bundled payments for care improvement advanced–BPCI Advanced) that will test a new iteration of bundled payment for the following thirty-two (32) clinical episodes:

29 Inpatient Clinical Episodes

Acute myocardial infarctionBack & neck except spinal fusion

Cardiac arrhythmia

Cardiac defibrillator

Cardiac valve

Cellulitis

Cervical spinal fusion

COPD, bronchitis, asthma

Combined anterior posterior spinal fusion

Congestive heart failure

Coronary artery bypass graft

Disorders of the liver excluding malignancy, cirrhosis, alcoholic hepatitis *
*(New episode added to BPCI Advanced)

Double joint replacement of the lower extremity

Fractures of the femur and hip or pelvis

Gastrointestinal hemorrhageGastrointestinal obstruction

Hip & femur procedures except major joint

Lower extremity/humerus procedure except hip, foot, femur

Major bowel procedure

Major joint replacement of the lower extremity

Major joint replacement of the upper extremity

Pacemaker

Percutaneous coronary intervention

Renal failure

Sepsis

Simple pneumonia and respiratory infections

Spinal fusion (non-cervical)

Stroke

Urinary tract infection