Five Reasons You Can Benefit From the New Voluntary Bundles

Philip Betbeze, February 8, 2018

Going forward, it will be important for such programs to create and monitor the measures they track, says Lassen.

"CMS has seven quality indicators in this. Your organization will be judged on them, and your bonus will be contingent on them, not just on the cost," he says.

The new voluntary bundles can pay off for five reasons, he says:

1. Investments haven't been wasted

The introduction of the new BPCI Advanced model underscores that those who have already made an investment did not throw their money down the drain, says Lassen. The introduction of specific voluntary bundles means those who want to move further down the risk curve can do so, and at their own pace.

"A lot of people made a lot of investments and none of that goes to waste," says Lassen. "You can continue to deploy that capital."

That means investments in outpatient care networks or integrated electronic medical records, or team-based healthcare, such as multidisciplinary rounding to identify gaps in care that may lengthen stays, could still deliver ROI, if the organization is willing to take on risk through the voluntary advanced payment models.

2. Comprehensive bundles

Lassen advocates applying for and participating in a comprehensive and diversified group of bundles instead of just cherry-picking high-risk conditions.

That includes adding outpatient bundles, which represent three of the 32 available bundles under BPCI Advanced, and helps an organization move more quickly from a largely fee-for-service model to a value-based one.

"I wish there were more [bundles]," he says. "This expands program size and allows for opportunities for equal or better outcomes in the less expensive settings. Also, we see a lot more hospital-payer-physician relationships centered on those outcomes."

3. Physician involvement

The new bundle offers opportunities for physicians to get involved, a critical constituency to making bundling work, says Lassen, based on his commercial bundling experience. The BPCI Advanced bundles are not just hospital-driven or convener-driven.

"Now, nonconvener groups, including physician groups, can bear or apportion risk," he says. "What's so good about it is that not being hospital-driven, physicians can choose whether to be aligned with the hospitals, because they really control the care. It's never been that way, so physicians should be very happy."

4. No MIPS!

Although a certain portion of their work must be in the advanced model to get the bonus, now that physicians can participate in upside and downside risk through BPCI Advanced, they will not have to do MIPS reporting.

Philip Betbeze

Philip Betbeze is the senior leadership editor at HealthLeaders Media.

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