Key areas of cardiovascular care included in CMS’s voluntary bundled payment model

The new voluntary bundled payment model announced by CMS on Jan. 9 offers payment for 32 clinical episodes, including several of the cardiovascular variety.

Beginning Oct. 1, providers can commit to being held accountable for one or more of clinical episodes in the Bundled Payments for Care Improvement-Advanced Model (BPCI-A), which offers a track to collect a 5 percent bonus payment through the Advanced Alternative Payment Model (AAPM) track of the Quality Payment Program established by the Medicare Access and CHIP Reauthorization Act (MACRA). As with all AAPMs, there is financial risk involved for providers.

Regarding cardiovascular care, providers may opt to participate in the program for percutaneous coronary intervention, coronary artery bypass graft (CABG), heart failure, stroke, acute myocardial infarction (AMI), pacemakers, chronic obstructive pulmonary disease and cardiac valves, defibrillators and arrhythmias. Payment will be awarded based on performance in quality measures including hospital readmissions, excess days in acute care following AMI, patient safety indicators and 30-day risk-standardized mortality rates following CABG.

“BPCI Advanced builds on the earlier success of bundled payment models and is an important step in the move away from fee-for-service and towards paying for value,” CMS Administrator Seema Verma, MPH, said in a statement. “Under this model, providers will have an incentive to deliver efficient, high-quality care.”

The application period for participation in the BPCI-A began Jan. 11 and ends March 12. The program will continue through 2023.