New section

Content Background

New section

New section

The AAMC Alternative Payments (AP) Unit was formed in 2012, when the AAMC became a facilitator convener in the Bundled Payments for Care Improvement (BPCI) initiative. Since then, the AP Unit has worked to support the abilities of academic medical centers (AMCs) to adapt and thrive under alternative models of payment, as measured by the AMCs’ success in managing cost and improving quality. As part of this effort, the AP Unit offers learning collaboratives that provide advocacy support, data and policy analyses, project management services, and facilitated webinars, conference calls, and small-group learning for member AMCs.

The AP Unit currently offers targeted support for AMC members in three bundled payment programs:

  • Bundled Payments for Care Improvement (BPCI) Model 2

  • Comprehensive Care for Joint Replacement (CJR)

  • Oncology Care Model (OCM)
     

For questions regarding BPCI Advanced, or on how the AAMC will be supporting AMCs and health systems, please email the AAMC Alternative Payment team at aamcbundledpayments@aamc.org.

Medicare Access & CHIP Reauthorization Act (MACRA)

The AAMC has developed resources to help member institutions with the MACRA transition. These resources provide specific information for large-multi specialty group practices planning to report as groups under the new quality payment program. Furthermore, these resources include FAQs, checklist to prepare for MACRA, detailed info on group reporting requirements, and webinars and much more. Please note that some of the resources require your AAMC login information. All of our MACRA resources are available on our website at www.aamc.org/MACRA.

News & Updates

BPCI Advanced

On April 24, 2019, CMS/CMMI announced their new updates to Bundled Payments for Care Improvement Advanced (BPCI Advanced). This update changed the model to include 37 different Clinical Episodes (including 4 outpatient procedures). The model continues to examine the costs of care for these episodes from the initiation of treatment and the ensuing 90 days. In accordance with their previous directive, CMS has stated participation in this payment plan will be voluntary and it qualifies as an advanced APM. The program will allow both hospital and PGP participants. The deadline for applications was June 24, 2019. To date, this is the last open period in which to apply. The program is set to run until December 31, 2023.

The AAMC hosted a webinar on May 14, 2019, to review BPCI Advanced. Watch now (56-minute runtime); slides are available here (PDF).

Bundled Payments for Care Improvement (BPCI)

The Bundled Payments for Care Improvement (BPCI) initiative consists of four models of care under which providers are incentivized to coordinate to efficiently provide high-quality care to Medicare beneficiaries. Participants can accept financial risk for up to 48 different clinical conditions, or “episodes.” Members of the AAMC’s convened group participate in BPCI Model 2, under which the totality of a patient’s care for a given clinical condition is retrospectively reconciled against a target amount. Under Model 2, episodes begin with a hospital admission and last 30, 60, or 90 days post-discharge.

The AAMC has served as a facilitator convener since the onset of BPCI and currently supports about 30 hospitals as part of the AAMC BPCI Facilitator Convener Group. The AAMC provides advocacy support, data and policy analyses, project management services, and facilitated learning. Data services are enhanced through the AAMC’s partnership with DataGen and Singletrack Analytics.

Comprehensive Care for Joint Replacement (CJR)

The Comprehensive Care for Joint Replacement (CJR) model is a mandatory bundled payment program for hospitals located in 67 metropolitan statistical areas (MSAs). Hospitals that meet quality and cost thresholds for their Medicare lower-extremity joint replacement patients are eligible to receive savings. Episodes begin with a hospital admission and extend 90 days post-discharge. The risk phase of CJR started on April 1, 2016, and lasts for five years.

The AAMC launched the CJR Collaborative in spring 2016 and currently supports 15 hospitals in implementing the mandated program. The AAMC provides advocacy support, data and policy analyses, project management services, and facilitated learning Data services are enhanced through the AAMC’s partnership with DataGen and Singletrack Analytics.

Oncology Care Model (OCM)

The Oncology Care Model (OCM) is a voluntary cancer bundled payment program that includes all cancer types. Episodes are triggered by the administration of chemotherapy and last six months. Participants receive monthly per-beneficiary payments to provide enhanced services, such as 24/7 access to a clinician. Participants that meet certain quality and cost thresholds are eligible to receive savings.

The AAMC has launched an OCM Collaborative for AMC participants. The AAMC provides advocacy support, data and policy analyses, project management services, and facilitated learning.

New section