The Administrative Quality Measures Set, used starting in Model Year 1, contains seven exclusively claims-based measures directly collected by CMS. In doing so, the Center intends to provide Participants the flexibility to report quality measure performance through either an Administrative Quality Measures Set or an Alternate Quality Measures Set in Model Year 5. The CMS Innovation Center has engaged extensively with stakeholders to identify more targeted and actionable quality measures that better reflect performance within clinical episodes. An overarching goal of the Model is to promote seamless, patient-centered care throughout each clinical episode, regardless of which health care provider(s) is/are responsible for a specific element of that care. BPCI Advanced aims to help hospitals and clinicians work more collaboratively to achieve these goals, which have the potential to improve the beneficiary/patient experience and align to the CMS Quality Strategy goals of promoting effective communication and care coordination, highlighting best practices, and making care safer and more affordable. The Model rewards providers for delivering services more efficiently, supports enhanced care coordination, and recognizes high quality care. The Bundled Payments for Care Improvement (BPCI) Advanced Model reimburses Participants for clinically appropriate services provided to Medicare beneficiaries throughout an entire clinical episode using a voluntary bundled payment methodology.

Service quality measures models