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This Week in Managed Care: June 15, 2018
June 15, 2018

AHA Asks CMS to Delay New Bundled Payment Model

Allison Inserro
The American Hospital Association (AHA) recently asked CMS to delay the application deadline for its new bundled payment model by about a month so that additional programmatic information can be communicated to healthcare providers, systems, and clinicians. The AHA asked for the new information to be released by March 1 and for the program’s application deadline to be delayed from March 12 to April 16.
The American Hospital Association (AHA) recently asked CMS to delay the application deadline for its new bundled payment model by about a month so that additional programmatic information can be communicated to healthcare providers, systems, and clinicians.

The Bundled Payments for Care Improvement Advanced Model (BPCI Advanced) was announced January 9. 

The AHA, in a letter sent last week to CMS Administrator Seema Verma, said that it “agrees with the principles underlying the BPCI Advanced model and believes it could help further these efforts to transform care delivery through better aligned incentives for providers, as well as through performance and financial accountability. In addition, the AHA appreciates that CMS designed the BPCI Advanced model to qualify as an advanced alternative payment model (APM) under the Quality Payment Program (QPP) established by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.”

However, the AHA asked CMS to provide more information about BPCI Advanced and made specific requests and recommendations about how it is hoping CMS will structure the program. The AHA asked for the new information to be released by March 1 and for the program’s application deadline to be delayed from March 12 to April 16.

“Our members support the health care system moving toward the provision of more accountable, coordinated care and are redesigning delivery systems to increase value and better serve patients,” wrote AHA Executive Vice President Tom Nickels. But the AHA said there is concern about “the lack of sufficient operational detail about the model, making it difficult for hospitals and clinicians to make well-informed decisions as to participation.”

Specifically, the letter questions how CMS determines target prices, participation requirements and risk, regulatory relief, exclusions from bundled payment, attribution methodology, use of quality measures in payment determination (including a socioeconomic adjustment to the readmission, complication, and mortality measures), and data sharing.

The AHA also wants CMS to reconsider its decision to not allow hospital-convened BPCI Advanced models to count toward QPP criteria for a Merit-based Incentive Payment System APM.

 
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