Nurse Speaking to Patients

On February 21, 2023, CMS released the Request for Applications (RFA) for a two-year extension of the Bundled Payments for Care Improvement Advanced (BPCI-A) model with a deadline to apply by May 31, 2023. Organizations that apply by May 31 will have more options to participate in or withdraw from this voluntary alternative payment model (APM) in fall 2023. FORVIS has already seen dozens of provider organizations decide to submit a new application to participate.

BPCI-A can be a low-barrier entry point to gain experience in managing beneficiary cost of claims beyond the providers’ care setting. Specifically, applying for BPCI-A allows leaders and physicians to research rich, detailed beneficiary claims data on historical performance through an episodic lens. This same data also helps facilitate strategic decision-making to prepare organizations for future mandatory value-based care scenarios.

Key Considerations

  • Application is non-binding, allowing several months of no-risk analysis
  • Participation is voluntary with 90-day termination options
  • Claims data and target prices will be provided after initial application submission
  • Applicants start January 2024 for up to two (2) years

How FORVIS Can Help

FORVIS has successfully helped hundreds of providers navigate BPCI-A application, analysis, participation, strategies, and financial opportunities. Since 2018, organizations working with FORVIS have earned significant gains from BPCI-A participation and continue to look for new bundled payment opportunities. FORVIS’ team of experienced consultants is prepared to help in the following ways:

  • Facilitate application process, including data collection and essay responses
  • Ingest and analyze claims data to determine BPCI-A financial, clinical, and operational opportunities
  • Support selection activities for eligible episode groupings 
  • Develop BPCI-A governance and management design
  • Advise on best practices for care pathways, clinical risk management, discharge protocols, waiver utilization, beneficiary identification, and post-acute network development
  • Advance physician alignment opportunities with specialist providers involved in BPCI-A episodes
  • Monitor monthly episodic claims data during at-risk participation

If you have any questions or need assistance, please reach out to a professional at FORVIS or submit the Contact Us form below.

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