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New CMS BPCI Advanced Bundled Payment Model: Risks, Regulatory Requirements, Implementation Challenges

Recording of a 90-minute CLE webinar with Q&A

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Conducted on Tuesday, April 24, 2018

Recorded event now available

or call 1-800-926-7926

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.


On January 9, 2018, CMS launched its new voluntary BPCI Advanced model, to begin on October 1, 2018 and run through 2023.

Under the traditional Medicare fee-for-service payment model, Medicare pays providers for each service performed. Under the BPCI Advanced model, participants can earn additional revenue if the total expenditures for a beneficiary’s episode of care are kept below an overall spending target. BPCI Advanced will qualify as an Advanced Alternative Payment Model (APM) under the Quality Payment Program.

BPCI Advanced participants will bear some financial risk and payments will be adjusted for quality performance. Participants must use EHR technology and modify their delivery of healthcare services to reduce Medicare expenditures. Healthcare providers and their legal counsel face significant legal and regulatory issues in structuring such bundled payment arrangements.

Listen as our authoritative panel examines CMS’s new BPCI Advanced model.



  1. Description of the new BCPI Advanced model, including participation requirements
  2. Successful implementation of the BCPI Advanced model
  3. Key legal issues


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


Harris, John
John M. Harris, MBA


Mr. Harris combines consulting expertise with a hands-on management background. His 30 years of healthcare experience...  |  Read More

Madhani, Sheila
Sheila Madhani

Senior Director

Ms. Madhani advises clients on a wide variety of Medicare payment and regulatory issues. With more than 10 years of...  |  Read More

Rich, J. Peter
J. Peter Rich

McDermott Will & Emery

Mr. Rich practices almost exclusively in the healthcare field, advising hospitals, medication groups, and health plans,...  |  Read More

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