The Bundled Payments for Care Improvement initiative is comprised of four broadly defined models of care, which link payments for multiple services beneficiaries receive during an episode of care. Under the initiative, organizations enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality and more coordinated care at a lower cost to Medicare. For more information on the background of this initiative, various types of models, or details on episodes of care, visit BPCI Initiative: General Information. For more information on the other models, visit the BPCI Initiative: Model 2 web page, or BPCI Initiative: Model 3 web page, or BPCI initiative: Model 4 web page.
There are 11 participants/awardees involved in the BPCI Model 1: Retrospective Acute Care Hospital Stay Only. Many participants/awardees comprise numerous sites and can be accessed as a (List).
To view an interactive map of this Model, visit the Where Innovation is Happening page.
In Model 1, the episode of care is defined as the inpatient stay in the acute care hospital. Medicare pays the hospital a discounted amount based on the payment rates established under the Inpatient Prospective Payment System used in the original Medicare program. Medicare continues to pay physicians separately for their services under the Medicare Physician Fee Schedule.
Applications to participate in Model 1 were due in November 2011. On January 31, 2013, CMS announced the selection of Awardees into Model 1 and participation began in April, 2013. In the summer of 2013, CMS had an open period to allow organizations to submit new requests to participate in BPCI Model 1 and one new Awardee was added in January, 2014.
Model 1 Awardees
The information below represents BPCI Model 1 Awardees as of July 1, 2015 which are actively testing BPCI at one or more episode-initiating sites:
- Inspira Medical Center Elmer (Elmer, NJ)
- Inspira Medical Center Vineland (Vineland, NJ)
- Inspira Medical Center Woodbury (Woodbury, NJ)
- Kansas Surgery & Recovery Center (Wichita, KS)
- Robert Wood Johnson University Hospital (New Brunswick, NJ)
- Robert Wood Johnson University Hospital Rahway (Rahway, NJ)
- Saint Clare's Hospital (Denville/Dover) (Denville, NJ)
- Saint Peter's University Hospital (New Brunswick, NJ)
- St. Joseph's Regional Medical Center, St. Joseph's Wayne Hospital (Wayne, NJ)
- St. Mary's Hospital Passaic (Passaic, NJ)
- University Medical Center of Princeton at Plainsboro (Plainsboro, NJ)
Convening organizations that bring together multiple health care providers:
- New Jersey Hospital Association (NJHA) (Princeton, NJ)
- BPCI initiative: General Information
- BPCI initiative: Model 2
- BPCI initiative: Model 3
- BPCI initiative: Model 4
- BPCI Initiative Episode Analytic File (ZIP) (updated 07/15/15)