New CMS BPCI Advanced Bundled Payment Model: Risks, Regulatory Requirements, Implementation Challenges
Recording of a 90-minute CLE webinar with Q&A
This CLE course will discuss the new Centers for Medicare & Medicaid Services (CMS) “Bundled Payments for Care Improvement Advanced” (BPCI Advanced) model. The panel will discuss the participation requirements and potential benefits and risks. They will also examine the BPCI Advanced model’s relationship with MIPS and ACOs, and offer insights to overcome implementation challenges.
Outline
- Description of the new BCPI Advanced model, including participation requirements
- Successful implementation of the BCPI Advanced model
- Key legal issues
Benefits
The panel will review these and other critical issues:
- Overview of the BCPI Advanced model application process, including the overall model framework, the participation requirements and opportunities, and the application and participation timeline
- How the BPCI Advanced model aligns with Medicare’s Quality Payment Program and other Medicare value-based payment initiatives
- Provider and stakeholder responses to the new model
- Key drivers of success, including analytics, post-acute strategy and physician engagement including the management of physician relationships
- How to evaluate episode options and determine which episodes are likely to be successful
- The BPCI Advanced model’s interaction with ACOs and other value-based arrangements
- Availability of gainsharing/fraud and abuse waivers and issues
- Whether to use a convener and the negotiation and key provisions of the provider-convener contract
- Negotiation and key provisions of “collaborator agreements” with providers and ACOs that participate in the bundled payment arrangement (including Net Payment Reconciliation Amount on “NPRA Sharing providers”)
- Limitations on financial arrangements with NPRA sharing partners
- Potential state managed care and medical practice act regulatory issues
Faculty
John M. Harris, MBA
Director
Veralon
Mr. Harris combines consulting expertise with a hands-on management background. His 30 years of healthcare experience... | Read More
Mr. Harris combines consulting expertise with a hands-on management background. His 30 years of healthcare experience includes founding a healthcare business, running facilities and consulting to hospitals and health systems, ACOs, CINs, PHOs, IPAs, and health plans. Mr. Harris’ work for clients includes advising on strategic issues, and assisting with M&As and affiliation strategies.
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Sheila Madhani
Senior Director
McDermott+Consulting
Ms. Madhani advises clients on a wide variety of Medicare payment and regulatory issues. With more than 10 years of... | Read More
Ms. Madhani advises clients on a wide variety of Medicare payment and regulatory issues. With more than 10 years of experience, she is highly skilled in the areas of Medicare physician and hospital outpatient payment, Medicare quality programs, and the establishment and valuation of CPT® codes. Ms. Madhani has a deep understanding of emerging technology’s impact on Medicare reimbursement.
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J. Peter Rich
Partner
McDermott Will & Emery
Mr. Rich practices almost exclusively in the healthcare field, advising hospitals, medication groups, and health plans,... | Read More
Mr. Rich practices almost exclusively in the healthcare field, advising hospitals, medication groups, and health plans, as well as health industry clients. He has formed and restructured many types of managed care organizations, including ACOs, other types of physician-hospital organizations and similar integrated healthcare delivery systems, as well as HMOs and other types of health plans.
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