News: Study shows 47% of hospitals dropped out of bundled payment initiative

Only 12% of eligible hospitals signed up for CMS’ Bundled Payments for Care Improvement (BPCI) Model 2 initiative and 47% of them dropped out completely within two years, according to a recent study by the Journal of the American Medical Association (JAMA) published on the same day that CMS announced the new BPCI Advanced voluntary payment model.

For the study, JAMA evaluated the data from January 2014 to January 2017 for BPCI Model 2, since this track is selected by more than 99% of hospitals in the program, the study said. Dropouts of this model were defined as hospitals that initiated participation but were absent from participant lists prior to the planned end date, JustCoding reported.

According to the study, a total of 422 hospitals were participating in the BPCI Model 2 initiative in January 2017, which included 12% of the 3,523 hospitals eligible. Hospitals participating in the payment program were typically urban (99.1%), nonprofit (80.8%), teaching hospitals (50.5%), and had a greater number of beds than the average hospital, the study said.

During the study period, 88 hospitals fully dropped, 150 dropped out for less than one condition, and 184 continued with the initiative. Assessed by rates of hospital-condition pair (the number of hospitals multiplied by the number of conditions per hospital) dropouts climbed at six, 12, 18, and 24 months following enrollment (11.4%, 28.4%, 39.9%, and 47%, respectively), JustCoding reported.

The BPCI initiative launched in 2013 as a voluntary alternative payment model that holds participating facilities accountable for quality and costs in 30-, 60-, or 90-day episodes of care, CMS says. Participants can join for as many or as few as 48 eligible conditions as they wish and drop out without penalty. If cost targets are achieved, participants keep a portion of the savings; if cost targets are exceeded, participants reimburse Medicare a portion of the difference, according to JustCoding.

Editor’s note: This article originally appeared in JustCoding. To read the full study from JAMA, click here. To read about the new BPCI Advanced payment model, click here.