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Navigating BPCI-A Is a Time to Be Bold

Darcie Hurteau has worked in the healthcare industry for more than 15 years. For the last 10 years, Darcie has helped hospitals and other healthcare providers understand changes in Medicare's reimbursement systems. As Director, she leads the DataGen team that provides decision support and education to hospitals and health systems across the country as they prepare for health reform payment strategies. Darcie started her career in healthcare finance at Albany Medical Center in Albany, New York.
Organizations that want to change are not the same as organizations that are willing to change. It takes a bold leader to make recommendations that may be new and uncomfortable to the organization. As consultants who analyze complex data on a daily basis, we’re constantly steering our clients to make decisions—including some that may be well outside of their comfort zone. The trend toward more mandatory bundled payment models from CMS will be a forcing function that pushes organizations to make bold decisions and transform their businesses—or fail.

Voluntary models like BPCI-Advanced (BPCI-A), the successor to Bundled Payments for Care Improvement, should be viewed as a sandbox to prepare for this future of mandatory alternative payment models. Now is the time to raise the bar on what’s comfortable – and keep raising it. Now is the time to be bold.

We are passionate about using bundled payment models as innovative solutions for business transformation. Participation can lead to improved quality outcomes and patient/provider satisfaction while lowering costs, and using these models will prepare organizations for the future of value-based care.

Here are 4 things to think about when analyzing whether BPCI-A is right for your organization:

  • Evaluate the opportunity and risk areas for your organization: based on analysis of your organization’s data, is this the right program to participate in? If yes, where are the ongoing efforts or teams already in place that you could align with, where this work is a good fit?
  • Identify physician leaders who will be critical to this work and begin forming teams around areas of focus where you can gain attention
  • Develop your post-acute partnership strategy and identify post-acute pathway risk areas with gaps that must be addressed
  • Evaluate staffing and infrastructure needs and identify partners to support your work

Give your organization a leg up in the value-based care environment of tomorrow by moving boldly towards this change today. More mandatory bundled payment models are coming, so it makes sense to the experience you need to effect positive change. BPCI-A can be a great means to decrease readmissions, length of stay, and post-acute utilization while improving internal cost savings, patient/provider satisfaction, and achieving CMS savings. If that sounds good, ask yourself these 3 questions: Do you want to change? Are you willing to change? Are you willing to lead boldly?

Author Information

Darcie Hurteau, MBA, is senior director, DataGen. Tamara Cull, DHA, is senior vice president, Aveus.

About Aveus

The Aveus team offers 20 years of experience in providing strategic consulting, operational and advisory services, value-based program design, integrated care management models, and innovation implementation.

About DataGen

DataGen is an essential partner to healthcare organizations across the country, illustrating the financial implications of payment policy changes and promoting a pragmatic view of how changes will affect revenue and profitability.

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