BPCI Model 2: Retrospective Acute & Post Acute Care Episode

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.

Select anywhere on the map below to view the interactive version BPCI Model 2 Mapped

There are 741 participants/awardees involved in the BPCI Model 2: Retrospective Acute & Post Acute Care Episode. 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.

Background

Model 2 involves a retrospective bundled payment arrangement where actual expenditures are reconciled against a target price for an episode of care. Under this payment model, Medicare continues to make fee-for-service (FFS) payments to providers and suppliers furnishing services to beneficiaries in Model 2 episodes. The total expenditures for a beneficiary’s episode is later reconciled against a bundled payment amount (the target price) determined by CMS. A payment or recoupment amount is then made by Medicare reflecting the aggregate performance compared to the target price. In Model 2, the episode of care includes a Medicare beneficiary’s inpatient stay in the acute care hospital, post-acute care and all related services during the episode of care, which ends either 30, 60, or 90 days after hospital discharge. Awardees select up to 48 different clinical episodes to test in the model. For more information on the other models, visit the BPCI Initiative: Model 1 web page, BPCI Initiative: Model 3 web page, or BPCI Initiative: Model 4 web page.

On January 31, 2013, the first cohort of BPCI participants was announced. By October 1, 2013, some BPCI participants entered into Awardee Agreements with CMS, at which point they began bearing financial risk. In November 2013, CMS offered a second Open Period for current Awardees to add additional Episode Initiators or clinical episodes in BPCI Model 2. The second cohort of participants began their performance period on January 1, 2014. CMS offered a third Open Period in February 2014 seeking additional organizations to participate in BPCI Model 2. The Open Period ended on April 18, 2014, and resulted in many new participants joining BPCI initiative through the summer and fall of 2014.  Additional cohorts began on January 1, April 1, and July 1, 2015.

Model 2 Awardees

As of July 1, 2015, BPCI Model 2 has 741 participants in Phase 2. The 741 participants are comprised of 205 Awardees and 536 Episode Initiators involved in care redesign. For Model 2, “Episode Initiator” means an acute care hospital or a physician group practice that triggers an episode of care. The breakdown of participants by provider type is as follows: Acute Care Hospitals (403), and Physician Group Practices (295). Some Awardees are not initiating episodes in BPCI and therefore are not included in the breakdown of participants by provider type.

The information below represents BPCI Model 2 Awardees as of July 1, 2015 which are actively testing BPCI in Phase 2 at one or more episode-initiating sites:

  • Abington Memorial Hospital (Abington, PA)
  • AccentCare Health Management, Inc. (Dallas, TX)
  • Aiken Regional Medical Centers Inc. dba Aiken Regional Medical Center (Aiken, SC)
  • Akron General Medical Center (Akron, OH)
  • Anderson Regional Medical Center (Meridian, MS)
  • AnewCare (Johnson City, TN)
  • Archway Health Advisors, LLC (Brookline, MA)
  • Arnot Ogden Medical Center (Elmira, NY)
  • Atlanticare Regional Medical Center, Inc. (Egg Harbor Township, NJ)
  • Aultman Hospital (Canton, OH)
  • Aventura Hospital and Medical Center (Aventura, FL)
  • Avera Mckennan Hospital & University Health Center (Sioux Falls, SD)
  • Avera St. Luke's Hospital (Aberdeen, SD)
  • Banner Health (Phoenix, AZ)
  • Baptist Medical Center (San Antonio, TX)
  • Bayonne Medical Center (Bayonne, NJ)
  • Bayshore Medical Center (Pasadena, TX)
  • Baystate Medical Center (Springfield, MA)
  • Bayview Physician Services, PC (Chesapeake, VA)
  • Beacon Health System (South Bend, IN)
  • BJC Healthcare (St. Louis, MO)
  • Blue Ridge Healthcare System-Grace Hospital Inc. (Morganton, NC)
  • Bon Secours Charity Health System dba Saint Anthony Community Hospital (Warwick, NY)
  • Bon Secours Mary Immaculate Hospital (Newport News, VA)
  • Borgess Medical Center (Kalamazoo, MI)
  • Bowling Green Warren County Community Hospital Corp. dba The Medical Center (Bowling Green, KY)
  • Buffalo General Medical Center (Buffalo, NY)
  • Cabell Huntington Hospital Inc. (Huntington, WV)
  • Canton-Potsdam Hospital (Potsdam, NY)
  • Carolinas Medical Center (Charlotte, NC)
  • Carolinas Medical Center Pineville (Charlotte, NC)
  • Catholic Health Initiatives (Englewood, CO)
  • Centegra Hospital – McHenry (McHenry, IL)
  • Centennial Hills Hospital Medical Center (Las Vegas, NV)
  • Centra Health, Inc. (Lynchburg, VA)
  • Chesapeake Regional Medical Center (Chesapeake, VA)
  • Christiana Care Health Services (Wilmington, DE)
  • Clear Lake Regional Medical Center (Webster, TX)
  • Cornerstone Regional Hospital LP dba Cornerstone Regional Hospital (Edinburg, TX)
  • Covenant Health, Inc. (Tewksbury, MA)
  • Coxhealth (Springfield, MO)
  • Delmarva Health Network, LLC (Lewes, DE)
  • Denton Regional Medical Center ( Denton, TX)
  • Desert Springs Hospital (Las Vegas, NV)
  • District Hospital Partners LP dba George Washington University Hospital (Washington, DC)
  • Doctors Hospital of Laredo (Laredo, TX)
  • Doctors Hospital of Williamsburg dba Riverside Doctors Hospital of Williamsburg (Williamsburg, VA)
  • Doylestown Hospital (Doylestown, PA)
  • Du Page Medical Group Ltd (Downers Grove, IL)
  • El Camino Hospital (Mountain View, CA)
  • EMH Regional Medical Center (Elyria, OH)
  • First Health Moore Regional Hospital (Pinehurst, NC)
  • Flagler Hospital, Inc. (St. Augustine, FL)
  • Flagstaff Medical Center (Flagstaff, AZ)
  • Florida Health Sciences Center, Inc. dba Tampa General Hospital (Tampa, FL)
  • Fort Duncan Medical Center LP dba Fort Duncan Medical Center (Eagle Pass, TX)
  • Geisinger Medical Center (Danville, PA)
  • Geisinger Wyoming Valley (Wilkes-Barre, PA)
  • Genesis Medical Center (Davenport, IA)
  • Good Samaritan Regional Medical Center (Suffern, NY)
  • Grand View Hospital (Sellersville, PA)
  • Greenville Health System (Greenville, SC)
  • Halifax Hospital Medical Center (Daytona Beach, FL)
  • Hattiesburg Clinic PA (Hattiesburg, MS)
  • Health Choice Preferred Accountable Care LLC (Franklin, TN)
  • Health Choice Utah Accountable Care LLC (Franklin, TN)
  • Heartland Regional Medical Center (St Joseph, MO)
  • Holy Name Medical Center (Teaneck, NJ)
  • Hospital for Special Surgery (New York, NY)
  • Hunterdon Medical Center (Flemington, NJ)
  • Infirmary Health System (Mobile, AL)
  • Inova Alexandria Hospital (Alexandria, VA)
  • Inova Fair Oaks Hospital (Fairfax, VA)
  • Inova Fairfax Hospital (Falls Church, VA)
  • Inova Loudoun Hospital (Leesburg, VA)
  • Inova Mount Vernon Hospital (Alexandria, VA)
  • JFK Medical Center (Atlantis, FL)
  • Jupiter Medical Center (Jupiter, FL)
  • Kent Hospital (Warwick, RI)
  • Kingwood Medical Center (Kingwood, TX)
  • Lahey Hospital and Medical Center (Burlington, MA)
  • Lake Health (Willoughby, OH)
  • Lakeland Regional Medical Center, Inc. (Lakeland, FL)
  • Lakewood Ranch Medical Center (Lakewood Ranch, FL)
  • Lancaster Hospital Corporation dba Palmdale Regional Medical Center (Palmdale, CA)
  • Liberty Health Partners LLC (Mercer Island, WA)
  • Lodi Memorial Hospital Association, Inc. (Lodi, CA)
  • Loma Linda University Health Care (Loma Linda, CA)
  • Lowell General Hospital (Lowell, MA)
  • Maine Heart Center (Portland, ME)
  • Manatee Memorial Hospital LP (Bradenton, FL)
  • Marshall Medical Center (Placerville, CA)
  • Mary Washington Health Alliance LLC (Fredericksburg, VA)
  • Maryview Hospital dba Bon Secours Maryview Medical Center (Portsmouth, VA)
  • McAllen Hospitals LP dba South Texas Health System (Edinburg,TX)
  • Medical Center of Plano ( Plano, TX)
  • Medical City Dallas Hospital (Dallas, TX)
  • Medsolutions, Inc. (Franklin, TN)
  • Memorial Health Services (Fountain Valley, CA)
  • Memorial Health University Medical Center (Savannah, GA)
  • Memorial Hospital Jacksonville (Jacksonville, FL)
  • Memorial Hospital Of Laramie County dba Cheyenne Regional Medical Center (Cheyenne, WY)
  • Memorial Regional Medical Center (Mechanicsville, VA)
  • Mercy Health Select, LLC (Cincinnati, OH)
  • Mercy St. Vincent Medical Center (Toledo, OH)
  • Meriter Hospital, Inc. (Madison, WI)
  • Methodist Dallas Medical Center (Dallas, TX)
  • Methodist Medical Center of Illinois (Peoria, IL)
  • Methodist Texsan Hospital, a Campus of Methodist Hospital (San Antonio, TX)
  • Milton S. Hershey Medical Center (Hershey, PA)
  • Montefiore Medical Center (Bronx, NY)
  • Mount Sinai Health System, Inc. (New York, NY)
  • Mount Sinai Hospital (Chicago, IL)
  • NaviHealth, Inc. (Brentwood, TN)
  • New York University Hospitals Center (New York, NY)
  • North Brevard County Hospital District dba Parrish Medical Center (Titusville, FL)
  • North Shore LIJ Health Care Inc. (Great Neck, NY)
  • Northwest Texas Healthcare System Inc. dba Northwest Texas Healthcare System (Amarillo, TX)
  • Northwestern Memorial Healthcare (Chicago, IL)
  • Novant Health, Inc. (Charlotte, NC)
  • Novato Community Hospital (Novato, CA)
  • NYU Lutheran Medical Center (Brooklyn, NY)
  • Ohio State University Hospitals (Columbus, OH)
  • OhioHealth Corporation (Columbus, OH)
  • Orlando Health, Inc. (Orlando, FL)
  • Ortho New England Group, LLC (Boston, MA)
  • Our Lady of Bellefonte Hospital Inc. (Ashland, KY)
  • Our Lady of The Lake Regional Medical Center (Baton Rouge, LA)
  • Palos Community Hospital (Palos Heights, IL)
  • Parma Community General Hospital (Parma, OH)
  • Peacehealth Sacred Heart – Riverbend (Springfield, OR)
  • Peacehealth St John Medical Center (Longview, WA)
  • Physicians of Central Florida PA (Mount Dora, FL)
  • Plaza Medical Center of Fort Worth (Ft. Worth, TX)
  • Presence Health Network (Chicago, IL)
  • Raleigh Orthopaedic Clinic, PA (Raleigh, NC)
  • Randolph Hospital Inc. (Asheboro, NC)
  • Rapid City Regional Hospital (Rapid City, SD)
  • Regional Medical Center of Orangeburg and Calhoun Counties (Orangeburg, SC)
  • Remedy BPCI Partners, LLC (Darien, CT)
  • Ridgeview Medical Center (Waconia, MN)
  • Riverside Community Hospital (Riverside, CA)
  • Riverside Hospital Inc. dba Riverside Regional Medical Center (Newport News, VA)
  • Riverside Middle Peninsula Hospital Inc. dba Riverside Walter Reed Hospital (Gloucester, VA)
  • Riverside Tappahannock Hospital Inc. (Tappahannock, VA)
  • Rush University Medical Center (Chicago, IL)
  • Saint Francis Downtown (Greenville, SC)
  • Saint Francis Medical Center (Midlothian, VA)
  • Saint Joseph Regional Medical Center-Mishawaka Campus (Mishawaka, IN)
  • Saint Mary's Hospital of Richmond Inc. (Richmond, VA)
  • Shore Health Services Inc. dba Riverside Shore Memorial Hospital (Nassawadox, VA)
  • Signature Healthcare (Brockton, MA)
  • Signature Medical Group, Inc. (Saint Louis, MO)
  • Silver Cross Hospital And Medical Centers, Inc. (New Lenox, IL)
  • Sisters of Charity Providence Hospitals (Columbia, SC)
  • South Nassau Communities Hospital (Oceanside, NY)
  • South Shore Physician Hospital Organization, Inc. (South Weymouth, MA)
  • Southwest General Health Center (Middleburg Heights, OH)
  • Sparks Family Hospital Inc. dba Northern Nevada Medical Center (Sparks, NV)
  • Spartanburg Regional Health Services District, Inc. (Spartanburg, SC)
  • Spring Valley Medical Center (Las Vegas, NV)
  • St Vincent’s Healthcare (Jacksonville, FL)
  • St. Bernard’s Hospital, Inc. (Jonesboro, AR)
  • St. Mary Medical Center Langhorne PA (Langhorne, PA)
  • St. Mary's Medical Center Of Evansville, Inc. (Evansville, IN)
  • Steward Integrated Care Network, Inc. (Boston, MA)
  • Stryker Performance Solutions, LLC (Chicago, IL)
  • Summerlin Hospital Medical Center LLC dba Summerlin Hospital Medical Center (Las Vegas, NV)
  • Swedish Covenant Hospital (Chicago, IL)
  • Temecula Valley Hospital Inc. dba Temecula Valley Hospital (Temecula, CA)
  • The Cleveland Clinic Health System (Independence, OH)
  • The Guthrie Clinic (Sayre, PA)
  • The Health Care Authority of the City of Huntsville (Huntsville, AL)
  • The Rutland Hospital (Rutland, VT)
  • The University of Texas Southwestern Medical Center at Dallas (Dallas, TX)
  • Torrance Memorial Medical Center (Torrance, CA)
  • Tucson Orthopaedic Institute, PC (Tucson, AZ)
  • UHS of Oklahoma Inc. dba St Mary's Regional Medical Center (Enid, OK)
  • UHS of Texoma, Inc. dba Texoma Medical Center (Denison, TX)
  • UHS-Corona, Inc. dba Corona Regional Medical Center (Corona, CA)
  • UMASS Memorial Medical Center, Inc. (Worcester, MA)
  • United Surgical Partners International Surgical Services (Addison, TX)
  • Universal Health Services of Rancho Springs Inc. dba Southwest Healthcare System (Murrieta, CA)
  • University Health Services, Inc. (Augusta, GA)
  • University Hospitals Cleveland Medical Center (Cleveland, OH)
  • University of Alabama Hospital (Birmingham, AL)
  • University of California Irvine dba UC Irvine Medical Center (Orange, CA)
  • University of California San Francisco Medical Center (San Francisco, CA)
  • University of Chicago Medicine (Chicago, IL)
  • University of Rochester Medical Center (Rochester, NY)
  • University of Utah Health Care (Salt Lake City, UT)
  • Valley Hospital Medical Center (Las Vegas, NV)
  • Vanderbilt University Medical Center (Nashville, TN)
  • VHS of Michigan - Detroit Medical Center (Detroit, MI)
  • Virtua West Jersey Health System Inc. (Voorhees, NJ)
  • Washington Regional Medical Center (Fayetteville, AR)
  • Wellington Regional Medical Center (Wellington, FL)
  • Wellmont Health System (Kingsport, TN)
  • Wentworth-Douglass Hospital (Dover, NH)
  • West Hills Hospital & Medical Center (West Hills, CA)
  • West Palm Beach Physician Group, Inc. (Sunrise, FL)
  • Westside Regional Medical Center (Plantation, FL)
  • White River Health System (Batesville, AR)
  • Winchester Medical Center, Inc. (Winchester, VA)
  • Winthrop-University Hospital (Mineola, NY)

Convening organizations that bring together multiple health care providers but are not Awardees or Episode Initiators:

  • Association of American Medical Colleges (Washington, DC)
  • Carolinas HealthCare System (Charlotte, NC)
  • Centegra Health System (Crystal Lake, IL)
  • Chatsworth at Wellington Green, LLC (Wellington, FL)
  • DNH Medical Management Inc. dba The Camden Group (El Segundo, CA)
  • Estes Park Institute, at Horty, Springer & Mattern (Pittsburgh, PA)
  • First Coast Health Alliance, LLC (St. Augustine, FL)
  • Geisinger Clinic (Danville, PA)
  • HCA Management Services, L.P. (Nashville, TN)
  • Navvis Healthcare, LLC (Ballwin, MO)
  • Premier, Inc. (Charlotte, NC)
  • Stryker Performance Solutions, LLC (Chicago, IL)

 

Three-Day Hospital Stay Waiver

A waiver of the 3-Day Hospital Stay Requirement for SNF Payment (“Waiver”) is available to Model 2 BPCI Awardees testing the episode payment model that spans the acute care hospitalization and post-discharge care, for an episode length that can range from 30 to 90 days. Under the Waiver, the requirement in Section 1861(i) of the Social Security Act for a 3-day inpatient hospital stay prior to Medicare Part A covered skilled nursing facility (SNF) services is waived for Model 2 Awardees, given certain provisions and requirements. The Waiver allows Model 2 BPCI beneficiaries who are discharged from an inpatient hospital stay of less than 3 days to receive post-hospital care from skilled nursing facilities (SNFs), covered under Medicare Part A, as long as all other coverage requirements are satisfied. The Waiver is made available to Awardees that provide a list of their SNF partners to CMS, where a majority of the SNF partners for a specified period of time had a quality rating of 3 or more stars under the CMS 5-Star Quality Rating System.

This Three-Day Hospital Stay Waiver document (PDF) reflects Model 2 Awardees that are currently eligible to utilize the Three-Day Hospital Stay Requirement for SNF Payment waiver, their Episode Initiators, and Model 2 episodes for which the Waiver can be used.

Additional Information