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[Federal Register Volume 79, Number 31 (Friday, February 14, 2014)]
[Notices]
[Pages 8974-8975]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-03311]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-5504-N4]

Medicare Program; Bundled Payments for Care Improvement Models 2, 
3, and 4 2014 Winter Open Period

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice.

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SUMMARY: This notice announces an open period for additional 
organizations to be considered for participation in Models 2, 3, and 4 
of the Bundled Payments for Care Improvement initiative.

DATES: Submission Deadline: Models 2, 3, and 4 Open Period intake forms 
must be submitted by April 18, 2014.

ADDRESSES: Interested organizations must submit their Models 2, 3, and 
4 Open Period intake forms via email at BundledPayments@cms.hhs.gov. 
All forms must be in a searchable word or PDF format.

FOR FURTHER INFORMATION CONTACT: For questions regarding Models 2, 3, 
and 4 of the Bundled Payments for Care Improvement initiative send an 
email to BundledPayments@cms.hhs.gov. For additional information on 
this initiative go to the CMS Center for Medicare and Medicaid 
Innovation (Innovation Center) Web site at http://innovation.cms.gov/initiatives/Bundled-Payments/Models2-4OpenPeriod.html.

SUPPLEMENTARY INFORMATION:

I. Background

    Section 1115A of the Social Security Act (the Act), as added by 
section 3021 of the Affordable Care Act, authorized the Center for 
Medicare and Medicaid Innovation to test innovative payment and service 
delivery models that reduce spending under Medicare, Medicaid, or CHIP, 
while preserving or enhancing the quality of care. Consistent with that 
authority, we seek to achieve the following goals:
     Improve care coordination, beneficiary experience, and 
accountability in a person-centered manner.
     Support and encourage providers that are interested in 
continuously reengineering care to deliver better care and better 
health at lower costs through continuous improvement.
     Create a cycle that leads to continually decreasing the 
cost of an acute or chronic episode of care while fostering quality 
improvement.
     Develop and test payment models that create extended 
accountability for better care, better health at lower costs for the 
full range of health care services.
     Shorten the cycle time for adoption of evidence-based 
care.
     Create environments that stimulate rapid development of 
new evidence-based knowledge.
    We are committed to achieving better health, better care, and lower 
costs through continuous improvement for Medicare, Medicaid and 
Children's Health Insurance Program (CHIP) beneficiaries. Beneficiaries 
can experience improved health outcomes and encounters in the health 
care system when providers work in a coordinated and person-centered 
manner. To this end, we are interested in partnering with providers 
that are working to redesign care to meet these goals. Payment 
approaches that reward providers that assume payment accountability for 
a particular ``episode'' of care are potential mechanisms for 
developing these partnerships.
    The Innovation Center is testing four episode payment models 
through the Bundled Payments for Care Improvement initiative. The 
current participants in the initiative were selected following a review 
of the applications submitted in response to a Request for Application, 
http://innovation.cms.gov/Files/x/Bundled-Payment-Request-for-Application.pdf released by the Innovation Center in August 2011. On 
January 31, 2013, the first set of BPCI Phase 1 participants were 
announced. Phase 2 began either on October 1, 2013 or January 1, 2014 
for Awardees that have entered into Model 2 Awardee Agreements with 
CMS, at which point Awardees began the risk-bearing phase for some or 
all of their episodes. The complete transition of all episodes for all 
episode initiators to Phase 2 will be completed by October 2014. During 
the transition period, Awardees may transition episodes and/or Episode 
Initiators that have remained in Phase 1 to Phase 2 on a quarterly 
basis.
    We began testing Model 1 of the initiative in April 2013. Model 1 
is a retrospective payment model for the acute inpatient hospital stay. 
In the May 17, 2013 Federal Register (78 FR 29139), we published a 
notice announcing an open period for additional organizations to be 
considered for participation in Model 1 of the initiative.
    Phase 2 of Models 2 through 4 began testing in October 2013. Models 
2, 3, and 4 are described as follows:
     Model 2--Retrospective bundled payment models for 
hospitals,

[[Page 8975]]

physicians, and post-acute providers for an episode of care consisting 
of an inpatient hospital stay followed by post-acute care.
     Model 3--Retrospective bundled payment models for post-
acute care where the episode does not include the acute inpatient 
hospital stay.
     Model 4--Prospectively administered bundled payment models 
for the acute inpatient hospital stay and related readmissions.

II. Provisions of the Notice

    To help us achieve the implementation goals noted previously, the 
Innovation Center is announcing a 2014 winter open period for 
additional organizations to be considered for participation in Models 
2, 3, and 4 of the initiative. We believe that increasing the number of 
Awardees and the types of episodes being tested would result in an even 
more robust data set and improve our evaluation of the models. 
Interested organizations must submit Model 2, 3 or 4 Open Period forms 
as specified in the DATES and ADDRESSES sections of this notice. 
Organizations may participate in more than one model. Organizations who 
are interested in participating in more than one model should submit a 
request to participate in each model using separate Open Period forms. 
Interested organizations can find information about the intake process, 
eligible organizations and providers, and model requirements on the 
Innovation Center Web site as specified in the FOR FURTHER INFORMATION 
CONTACT section of this notice.
    We will review the submitted intake forms and evaluate 
organizations for participation in Models 2, 3, and 4. We expect to 
offer Model 2, 3, or 4 participation agreements to those organizations 
that demonstrate their fitness for participation in the applicable 
Model. For information on the screening process go to the CMS Center 
for Medicare and Medicaid Innovation Web site as specified at: http://innovation.cms.gov/initiatives/Bundled-Payments/Models2-4OpenPeriod.html

III. Collection of Information Requirements

    Section 1115A(d) of the Act waives the requirements of the 
Paperwork Reduction Act of 1995 for purposes of testing and evaluation 
of new models or expansion of such models under section 1115A of the 
Act.

    Authority: Section 1115A of the Social Security Act (42 U.S.C. 
1315a)

(Catalog of Federal Domestic Assistance No. 93.773 Medicare--
Hospital Insurance Program; and No. 93.774, Medicare--Hospital 
Insurance Program; and No. 93.774, Medicare Supplementary Medical 
Insurance Program)

    Dated: February 10, 2014.
Marilyn Tavenner,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 2014-03311 Filed 2-13-14; 8:45 am]
BILLING CODE 4120-01-P
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