BPCI Model 1: Retrospective Acute Care Hospital Stay Only

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.

The BPCI Model 1: Retrospective Acute Care Hospital Stay Only concluded December 31, 2016.

Background

In Model 1, the episode of care was defined as the inpatient stay in the acute care hospital. Medicare paid the hospital a discounted amount based on the payment rates established under the Inpatient Prospective Payment System used in the original Medicare program. Medicare paid 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 participation included all DRGs for the eligible beneficiaries. The first cohort of Awardees in Model 1 began in April 2013 and concluded on March 31, 2016. The remaining Awardee concluded their participation on December 31, 2016.

Additional Information