On January 11, 2018, CMS announced a new voluntary episode payment model (bundled payments for care improvement advanced–BPCI Advanced) that will test a new iteration of bundled payment for the following thirty-two (32) clinical episodes:
29 Inpatient Clinical Episodes
| Acute myocardial infarction
Back & neck except spinal fusion Cardiac arrhythmia Cardiac defibrillator Cardiac valve Cellulitis Cervical spinal fusion COPD, bronchitis, asthma Combined anterior posterior spinal fusion Congestive heart failure Coronary artery bypass graft Disorders of the liver excluding malignancy, cirrhosis, alcoholic hepatitis * Double joint replacement of the lower extremity Fractures of the femur and hip or pelvis |
Gastrointestinal hemorrhage
Gastrointestinal obstruction Hip & femur procedures except major joint Lower extremity/humerus procedure except hip, foot, femur Major bowel procedure Major joint replacement of the lower extremity Major joint replacement of the upper extremity Pacemaker Percutaneous coronary intervention Renal failure Sepsis Simple pneumonia and respiratory infections Spinal fusion (non-cervical) Stroke Urinary tract infection |
3 Outpatient Clinical Episodes
Percutaneous Coronary Intervention (PCI)
Cardiac Defibrillator
Back & Neck except Spinal Fusion
A further explanation of the program can be accessed at the attached link: https://innovation.cms.gov/initiatives/bpci-advanced/
