bpci

Understanding your opportunity for BPCI success

The Centers for Medicare & Medicaid Services’ (CMS)Bundled Payments for Care Improvement (BPCI) initiative, introduced in October 2013, is instrumental in helping transform the healthcare industry.

Traditional fee-for-service payment models typically reimburse providers for quantity of servicesfurnished to a patient. The result is often a fragmented approach to care that lacks coordination across providers and settings. In contrast, healthcare bundled payments reward providers based on the quality of care, encouraging increased collaboration, thus reducing waste and improving patient outcomes.

Because transitioning to BPCI requires expertise and technology resources that most healthcare providers do not have in-house, many choose to work with a convener – an organization that helps providers better manage episodes of care to qualify for bundled payments. Conveners not only provide the capabilities and expertise needed to successfully manage a bundled payment program, but also share in the risk of managing patient care in this new model.

Simplify BPCI with naviHealth

naviHealth is the largest BPCI convener for health systems in the nation, working with more than 50 hospitals to improve the outcomes of roughly 40,000 episodes annually. Our high-tech, high-touch approach to healthcare management helps to improve patient outcomes while reducing waste, resulting in greater revenue potential for our partners. As a Cardinal Health company, with 18 years of experience in post-acute care management and care transitions, we provide clinical support services, scalable technologies and advisory solutions that help our clients successfully navigate the bundled payment system and the rapidly changing healthcare landscape.

To help you transition to BPCI, we offer:

  • More than 420 clinicians to help manage post-acute care and transitions.
  • Proprietary technology to impact and manage metrics in quality of care, efficiency, readmissions and skilled nursing facility (SNF) utilization.
  • Expertise in analyzing complex claim data sets and identifying potential areas for savings against benchmarks and best practices.

Our BPCI team includes former Center for Medicare & Medicaid Innovation (CMMI) staff as well as consultants who have designed and implemented CMS bundled payment programs throughout the nation.

An Experienced Partner

We’ve spent more than 18 years pioneering ways to improve every aspect of care transitions for health plans, providers and patients. From discharge planning efficiencies to managing risk for payors and providers, naviHealth is equipped to provide you with a tailored suite of capabilities.

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Benefits of partnering BPCI with naviHealth

When you choose naviHealth as your BPCI convener, your organization is better equipped to:

  • Improve patient outcomes by delivering better coordinated and higher quality of care.
  • Enhance the patient experience with improved discharge processes and post-acute care coordination.
  • Align physician incentives to improve care while reducing waste and increasing efficiencies.
  • Generate revenue by lowering post-acute care costs.
  • Lay the future groundwork for value-based Medicare reimbursement and payment reform readiness.

Learn more about managing BPCI with naviHealth.

The statements contained on this page are solely those of the author and do not necessarily reflect the views or policies of CMS. The author assumes responsibility for the accuracy and completeness of the information contained on here.


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