The Centers for Medicare & Medicaid Services (CMS) recently announced a new, voluntary bundled payment program, designed to curb Medicare costs for 32 different medical episodes by paying providers a single payment per episode. The new program puts hospitals and physicians in the driver’s seat, enabling them to select or convene care delivery partners and distribute financial benefits earned as a result of reducing the costs to Medicare. The new model, Bundled Payments for Care Improvement Advanced (BPCI Advanced), will replace existing voluntary BPCI models, including BCPI 3, which put skilled nursing providers in charge of care episodes. BPCI Advanced includes several incentives for participation among hospitals and physician groups, but not without drawbacks. If BPCI Advanced gains traction, skilled nursing providers may have to adapt to benefit from the model or risk being left out.
On Christmas Eve, the New York Times published an article describing measures the Centers for Medicare and Medicaid (CMS) took during 2017 to reduce fines levied against skilled nursing properties. The skilled nursing industry may view this change as a welcome respite from real or perceived government over-regulation, especially in an era of downward pressure on occupancy and constrained budgets. Nursing home resident advocates, on the other hand, may view this move as an affront to resident safety. Deregulation remains a top priority for President Trump, and therefore efforts to reduce penalties for nursing homes should not come as a surprise.