CMS is going to make key changes to Bundled Payments for Care Improvement (BPCI) Advanced next year to stop the model from generating financial losses of close to $2 billion over the model’s ten performance periods. Model year 4 will begin on Jan 1, 2021. CMS’s Innovation Center will modify target pricing calculations using an adjusted retrospective element.
There is one thing that participants need to choose clinical episodes groups versus individual episodes, address clinical episode overlap, remove the physician group practice offset, and alter risk adjustment for major joint replacement episodes.
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