CMS will allow participants to withdraw from new bundles in March 2019

CMS has announced participants in the Bundled Payment for Care Improvement (BPCI) Advanced model will be able to retroactively withdraw beginning in March 2019.

The move likely gives providers more assurance in their participation in the new Advanced Alternative Payment Model (APM), after the agency had not delivered certain price targets and data in a timely manner.

The model—a new voluntary episode payment model set to begin Oct. 1, 2018—bundles health care services into a single payment amount, incentivizing providers and suppliers to deliver coordinated care.

CMS made the announcement that participants can withdraw some or all episode initiators and clinical episodes from the model in March 2019 after industry groups, including the American Hospital Association, urged CMS to add additional start dates in 2019. Many applicants had not received information from CMS on episode target prices and other data, AHA claimed.

“While we are retaining our initial Oct. 1 start date, to accommodate this update in preliminary target prices and to recognize some applicants’ requests for a later start date, we will be allowing all participants to retroactively withdraw episode initiators and/or clinical episodes in March 2019,” the agency said.

 

BPCI Advanced includes 32 clinical episodes. Participants, beginning in October, must commit for one or more episodes. Originally, CMS stated participants could not add or drop such clinical episodes until January 2020 once the model began.

CMS also recently extended the deadline for participation agreements and selecting clinical episodes for BPCI Advanced to August 8. The deadline for deliverables due to CMS was pushed to September 14.