Quality Improvement for Institutions



Bundled Payments For Care Improvement (BPCI) Advanced


The Centers for Medicare and Medicaid Services (CMS) Bundled Payments for Care Improvement (BPCI) Advanced program  is a voluntary model that incentivizes participants to improve care coordination and quality of care and reduce the cost of care in up to 37 outpatient and inpatient clinical episodes. The second cohort, also known as Model Year 3, will begin on Jan. 1, 2020, and run through Dec. 31, 2023.

BPCI Advanced qualifies as an Advanced Alternative Payment Model (Advanced APM) under the Quality Payment Program (QPP). Clinicians who participate in this model and meet relevant payment or patient thresholds can qualify for the Advanced APM bonus and be exempt from the Merit-Based Incentive Payment System (MIPS).

Update: CMS has announced a delay in the implementation of Alternate Quality Measure sets, which included a number of registry reported quality measures,  until Model Year 4. As a result of the delay, the seven claims-based Administrative Quality Measures from Model Years 1 and 2 will continue to be used. These include:

  • NQF #0268 - Perioperative Care: Selection of Prophylactic Antibiotic: First or Second Generation Cephalosporin
  • NQF #0326 - Advanced Care Plan
  • NQF #1550 - Hospital-Level Risk-Standardized Complication Rate (RSCR) Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA)
  • NQF #1789 - All-cause Hospital Readmission Measure
  • NQF #2558 - Hospital 30-Day, All-Cause, Risk-Standardized Mortality Rate (RSMR) Following Coronary Artery Bypass Graft Surgery
  • NQF #2881 - Excess Days in Acute Care after Hospitalization for Acute Myocardial Infarction
  • CMS PSI 90 - CMS Patient Safety Indicators

CMS is expected to release updated fact sheets for each of these measures in the near future. Meanwhile, CMS has said it remains committed to expanding options for quality measure reporting and selection of clinically meaningful measures for future model years. The ACC will continue to work with CMS over the course of the year in preparation for Model Year 4.  


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