This past January 9th CMS announced Bundled Payment for Care Improvement (BPCI) Advanced. This five-year Medicare bundled or episode-based payment demonstration, that begins this October 1st, will succeed the agency'a five-year BPCI demonstration that sunsets this September 30th. BPCI Advanced, also voluntary, will be considerably less expansive than its predecessor in that, among other things, it will include just 32 clinical episodes (29 inpatient and three outpatient), and offer only a single, 90 day retrospective bundled payment under one risk track.
During this 28 minute interview Mr. Dave Terry briefly defines Archway's business model/s, posits what attributes describe successful bundled payment providers, summarizes the findings from a recent study, he coauthored, of BPCI reimbursed total hip arthroplasty surgeries, how CMS has improved bundled payments under BPCI Advanced, or moreover in financial benchmarking and in quality measurement, the legitimacy of criticisms regarding care fragmentation and competition with other pay for performance models and likely success of the demonstration.
Mr. Dave Terry is currently CEO of Archway Health. Previously, at Partners Healthcare in Boston, Mr. Terry negotiated global cap and pay for performance contracts with managed care plans. Prior still at Harborside Healthcare, he led a home care agency that managed Medicare and commercial episodes of care within a single payment. As a partner with The Chartis Group, Mr. Terry developed provider networks and risk sharing models for Medicare Accountable Care Organizations (ACOs). Mr. Terry holds an MBA from the Harvard Business School and a BA from Columbia University. He currently serves on the board of Bottom Line, a national educational non-profit, and is a past board member of the Harvard Business School Health Industry Alumni Association.
For information on BPCI Advanced to go: https://innovation.cms.gov/initiatives/bpci-advanced.
Unpacking BPCI, CMS' New Bundled Payment Demonstration: An Interview with Dave Terry (February 28th)