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
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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 *
*(New episode added to BPCI Advanced)
Double joint replacement of the lower extremity
Fractures of the femur and hip or pelvis
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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
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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/
