Industry Insights
Leading healthcare data analytics insights:
Most applicants in the Medicare BPCI Advanced program are evaluating participation in various episodes with the goal of achieving financial success by reducing costs in those episodes. Some innovative hospitals, however, are applying an additional criterion for participation in some episodes.
Along with the BPCI Advanced claims data, CMS provided to applicants with an Excel workbook named 2018_05_31_bpid-0000_Baseline_MY_1_2_Prelim_TP.xlsx containing the preliminary targets for all episode types in which the hospital had sufficient baseline episode volume. Those workbooks also contained the three factors that are used to adjust each hospital's baseline cost to compute the final target amount.
(Note - this article was written in 2015 referring to the BPCP program but remains relevant in BPCI Advanced.)