BPCI Model 3: Retrospective Post Acute Care Only

The Bundled Payments for Care Improvement (BPCI) initiative is comprised of four broadly defined models of care, which link payments for the 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

This map as well as the "Number of Participants" referenced in the "Model Summary" section in the upper right hand column on this page is populated by data which only includes episode initiating Participants in the Initiative. Currently, 645 Participants comprised of 631 episode initiating Awardees and Episode Initiators, and additional 14 non-episode initiating Awardees are involved in the BPCI Model 3: Retrospective Post Acute Care Only. Many participants/awardees comprise numerous sites and can be accessed as a (List).

Background

Model 3 involves a retrospective bundled payment arrangement where actual expenditures are reconciled against a target price for an episode of care. Under this model, Medicare continues to make fee-for-service (FFS) payments to providers and suppliers furnishing services to beneficiaries in Model 3 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 3, the Episode of Care is triggered by a Medicare beneficiary’s acute care hospital stay and begins at initiation of post-acute care services with a participating skilled nursing facility, inpatient rehabilitation facility, long-term care hospital or home health agency. The post-acute care services included in the episode of care must begin within 30 days of discharge from the inpatient stay and end 30, 60, or 90 days after the initiation of the episode of care. Participants can select up to 48 different clinical condition episodes to test in the model. For more information on the other models, visit the BPCI Initiative: Model 1 web page, BPCI Initiative: Model 2 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 3. 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 3. 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.

In December 2014, a timeline for transition to Phase 2 of BPCI was instituted.  According to the timeline, every episode initiating organization, regardless of whether the Episode Initiator is directly bearing risk (as an Awardee) or is participating under an Awardee Convener, had to transition at least one Clinical Episode to Phase 2 by July 1, 2015 in order to remain in BPCI. The transition of all clinical episodes for all participants into Phase 2 was completed on September 30, 2015 at which point Phase 1 of BPCI ended. Phase 2 was previously scheduled to end after each participant completed a three year period of performance for each clinical episode entered into Phase 2. The BPCI initiative has been extended until September 30, 2018 for all BPCI Model 2, 3, and 4 Awardees that choose to sign an amendment extending their period of performance for all clinical episodes for up to 2 years.

Model 3 Awardees

As of April 1, 2018, BPCI Model 3 has 645 participants in Phase 2. The 645 participants are comprised of 84 Awardees and 561 Episode Initiators involved in care redesign. For Model 3, “Episode Initiator” means a post-acute care provider or a physician group practice that triggers an episode of care. The breakdown of participants by provider type is as follows: Skilled Nursing Facilities (535), Home Health Agencies (46), Inpatient Rehab Facilities (9), Physician Group Practices (41) and Long Term Care Hospitals (0). 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 3 Awardees as of April 1, 2018 which are actively testing BPCI in Phase 2 at one or more episode-initiating sites:

  • Access Innovations LLC ( Worthington, OH)*
  • Assure Home Healthcare, Inc. (Skokie, IL)
  • Avamere Health Services (Wilsonville, OR)*
  • Belair Nursing & Rehabilitation Center (Bellmore, NY)
  • Bella Vita Health and Rehabilitation Center (Glendale, AZ)
  • Boulevard Temple Care Center (Detroit, MI)
  • Brooks Health System (Jacksonville, FL)*
  • Camelback Post Acute Care and Rehabilitation (Phoenix, AZ)
  • Chatsworth at Wellington Green, LLC (Palm Beach Gardens, FL)
  • Copper Ridge Health Care (West Jordan, UT)
  • Coronado Healthcare Center (Phoenix, AZ)
  • Diversicare Humble, LLC (Humble, TX)
  • Diversicare of Big Springs, LLC (Huntsville, AL)
  • Diversicare of Lake Highlands, LLC (Dallas, TX)
  • Diversicare of Providence, LLC (New Albany, IN)
  • Diversicare of Seneca Place, LLC (Louisville, KY)
  • Diversicare of Smyrna (Smyrna, TN)
  • Encompass Health Bundling Initiatives, LLC (Birmingham,  AL)*
  • Franciscan Village (Lemont, IL)
  • Genesis Care Innovations LLC (Kennett Square, PA)*
  • Glenwood Care Center (Oxnard, CA)
  • Good Samaritan Society - Specialty Care Community (Robbinsdale, MN)
  • Hartford Nursing & Rehab Center (Detroit, MI)
  • HCF of Shawnee, Inc.  dba Shawnee Manor (Lima, OH)
  • Horizon Home Health (Meridian, ID)
  • Horizon Post Acute and Rehabilitation Center (Glendale, AZ)
  • Huntington Hills Center For Health & Rehabilitation (Melville, NY)
  • Illinois Bone & Joint Institute, LLC (Des Plaines, IL)
  • Kith Haven (Flint, MI)
  • Liberty Health Partners LLC (Mercer Island, WA)*
  • Marycrest Manor (Livonia, MI)
  • McLean County Orthopedics, Ltd. (Bloomington, IL)
  • Midwest Orthopaedic Consultants, S.C. (Orland Park, IL)
  • Montecito Post Acute Care and Rehabilitation (Mesa, AZ)
  • Oak Park Nursing and Rehab Center LLC (Madison, WI)
  • Osborn Health and Rehabilitation (Scottsdale, AZ)
  • Park Manor Rehabilitation Center (Walla Walla, WA)
  • Park View Post Acute (Santa Rosa, CA)
  • Parker Jewish Institute for Health Care and Rehabilitation (New Hyde Park, NY)
  • Penacook Place, Inc. (Haverhill, MA)
  • Personal Home Care of North Carolina, LLC (Charlotte, NC)
  • Plum Healthcare Group, LLC (San Marcos, CA)*
  • Post Acute Care Network, LLC (Cincinnati, OH)*
  • Presbyterian Homes in the Presbytery of Lake Erie (1) (Erie, PA)
  • Presbyterian Homes in the Presbytery of Lake Erie (2) (Erie, PA)
  • Presbyterian Medical Center of Oakmont, Incorporated (Oakmont, PA)
  • Presbyterian Medical Center of Washington, Incorporated (Washington, PA)
  • Regency at Waterford (Waterford, MI)
  • Regency Heights-Detroit (Detroit, MI)
  • Remedy BPCI Partners, LLC (Darien, CT)*
  • Sabino Canyon Rehabilitation and Care Center (Tucson, AZ)
  • Saint Antoine Residence (North Smithfield , RI)
  • St. Elizabeth at Home (SEAH) dba Cathleen Naughton Associates, Inc. (Providence, RI)
  • Saint Elizabeth Home (East Greenwich, RI)
  • Saint Elizabeth Manor (Bristol, RI)
  • Samaritas (Detroit, MI)*
  • Sancta Hospital dba Sancta Maria Nursing Facility (Cambridge, MA)
  • Sanctuary at Fraser Villa (Fraser, MI)
  • Sanctuary at Holy Cross Indiana (South Bend, IN)
  • Sanctuary at McAuley (Muskegon, MI)
  • Sanctuary at St. Paul's (South Bend, IN)
  • Sanctuary at the Park (Muskegon, MI)
  • Sanctuary at the Shore (Grand Haven, MI)
  • Sanctuary at White Lake (White Lake, MI)
  • Sante Partners II, LLC (Scottsdale, AZ)*
  • Scandinavian Home, Inc. (Cranston, RI)
  • SHC LP Holdings, LLC (Louisville, KY)*
  • Signature Holdings II, LLC (Louisville, KY)*
  • Southland Care Center (Norwalk, CA)
  • St. Anthony Home (Crown Point, IN)
  • St. Clare Home for the Aged (Newport, RI)
  • St. Joseph Villa ( Salt Lake City, UT)
  • Steere House Nursing & Rehabilitation Center (Providence, RI)
  • Sunview Health and Rehabilitation Center (Youngtown, AZ)
  • THA Services, Inc. dba THA Group (Savannah, GA)*
  • The Peaks (Flagstaff, AZ)
  • The Pines at Poughkeepsie Center for Nursing & Rehabilitation (Poughkeepsie, NY)
  • Victoria Care Center (Ventura, CA)
  • Villa Saint Joseph of Baden, Incorporated (Baden, PA)
  • Visiting Nurse Services of Newport and Bristol Counties (Portsmouth, RI)
  • Visiting Nurse Service of NY Home Care II (New York, NY)
  • Westchester Gardens (Clearwater , FL)
  • Willowbend Nursing & Rehabilitation Center (Mesquite, TX)
  • Willowbrook Manor (Flint, MI)

* Organizations that are Awardees but non-episode initiating are not included in the "Number of Participants" referenced in the "Model Summary" section  of this page.

 

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

  • CareLink Inc. (Providence, RI)
  • Ciena Healthcare (Southfield, MI)
  • Covenant Health, Inc. (Tewksbury, MA)
  • Ensign Service, Inc. (Mission Viejo, CA)
  • Franciscan Sisters of Chicago Service Corporation (Homewood, IL)
  • Illinois Bone & Joint Institute, LLC (Des Plaines, IL)
  • The Evangelical Lutheran Good Samaritan Society (Sioux Falls, SD)
  • The Goodman Group, LLC (Chaska, MN)
  • Trinity Health Corporation (Livonia, MI)

Additional Information