The Bundled Payments for Care Improvement Advanced (BPCI-A) model differs from the original BPCI initiative in several ways, but three changes are key:
- All BPCI-A participants are exposed to potential financial penalties from day one, with no phase-in period for downside risk.
- All clinical episodes in BPCI-A consist of the anchor stay or procedure plus the 90-day post-acute period. Shorter 30-day and 60-day bundles are no longer an option, and the original BPCI acute-stay-only model has been discontinued.
- Up to 10% of payments are tied to quality, with seven quality measures covering both care processes and patient outcomes.