GLH has joined Medicare’s New Payment and Service Delivery Model
by GLH Staff
Greenwood Leflore Hospital has volunteered to take part in our Centers for Medicare & Medicaid Services (CMS) Bundled Payments for Care Improvement Advanced Model (BPCI Advanced) (view PDF). This doesn’t change your Medicare rights or benefits and you don’t need to do anything.
What are bundled payments?
A bundled payment combines, or bundles together, payments that Medicare makes to your health care providers for the many different kinds of medical services you might get in a specific time period. In BPCI Advanced, this time period could include a hospital inpatient stay or outpatient procedure, plus 90 days.
Why would Medicare bundle payments?
Bundled payments are thought of as a “value-based” way to pay because health care providers are responsible for both the quality and cost of medical care they give. This is a relatively new way of paying health care providers compared to the“fee-for-service” way Medicare has traditionally paid, where providers are paid separately for each service they provide. Bundled payments encourage these providers to work together to provide better, more coordinated care during your hospital stay, or outpatient procedure, and through your recovery.
What does BPCI Advanced mean for me?
You’re more likely to get even better care when hospitals, doctors, and other health care providers work together. In BPCI Advanced, hospitals, doctors, and other health care providers may be rewarded for providing better, more coordinated health care. Medicare will watch BPCI Advanced participants closely to make sure that you and other patients keep getting efficient, high quality care.
What do I need to know about BPCI Advanced?
What’s most important for you to know is that your Medicare rights and benefits don’t change because your health care provider is participating in BPCI Advanced. Medicare will keep covering all of your medically necessary services.
Even though Medicare will pay your doctor in a different way under BPCI Advanced, how much you have to pay won’t change. Health care providers and suppliers who are enrolled in Medicare will submit their Medicare claims like they always have. You’ll have all the same Medicare rights and protections, including the right to choose which hospital, doctor, or other health care provider you see. If you don’t want to get care from a health care provider who’s participating in BPCI Advanced, then you’ll have to choose a different health care provider who’s not participating in the Model.
How can I give feedback about my health care?
Medicare might ask you to take a voluntary survey about the services and care you received from GLH during your hospital stay or outpatient procedure and for a specific period of time afterwards. You can decide whether you want to take the voluntary survey, but if you do, it’ll help Medicare make BPCI Advanced and the care of other Medicare patients better.
If you have concerns or complaints about your care, you can:
• Talk to your doctor or health care provider.
• Contact your Beneficiary and Family Centered Care Quality Improvement
Organization (BFCC-QIO). You can get your BFCC-QIO’s phone number at Medicare.gov/contacts or by calling 1-800-MEDICARE. TTY users can call 1-877-486-2048.
Where can I learn more about BPCI Advanced?
Learn more about BPCI Advanced at
• A list of all the hospitals and physician group practices in the country participating in BPCI Advanced.
• All of the inpatient and outpatient Clinical Episodes that are currently included under BPCI Advanced. A Clinical Episode is a grouping of medical conditions or diagnoses that are included in the BPCI Advanced Model.