CMS' new voluntary bundled-payment model is attractive to providers

For MemorialCare Health System, the new model will appeal to its more than 2,000 employed or contracted specialty physicians because they don't have many options under MACRA now to join an advanced APM, said Dr. Adam Solomon, chief medical officer of the MemorialCare Medical Foundation.

Fountain Valley, Calif.-based MemorialCare has participated in the original Bundled Payments for Care Improvement initiative since 2015 with considerable success. Officials will have to decide if the new model is worth the financial risk and which clinical episodes work best.

"The actuarial math is significant," said Helen Macfie, MemorialCare's chief transformation officer.

The five-year program, set to run through 2023, allows participants to add or drop clinical episodes in 2020 during a second application process.

A substantial difference between the BPCI Advanced model and the Bundled Payments for Care Improvement initiative, which began in 2013, is that independent physician group practices can apply to join. The original program applied just to hospitals.

Independent doctors under MACRA's MIPS option will probably be drawn to the new model as an opportunity to move to an advanced APM, said Andrew Wilson, research team leader at the Altarum Center for Value in Health Care. "I think the incentive of the program as a way to get (physicians) out of the MIPS side of MACRA will be enough for doctors to seriously consider (participating in the model)," he said.

Some physicians have criticized MIPS because of its reporting requirements. The influential Medicare Payment Advisory Commission last week recommended scrapping MIPS, calling the program too burdensome.