Signify Health exiting CMS’ bundled payment program

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Signify Health, a value-based care-focused analytics platform, will be ceasing its Episodes of Care Services (ECS) business and exiting the Centers for Medicare and Medicaid Services’ Bundled Payments for Care Improvement-Advanced (BPCI-A) model, the company announced.

Signify said it was ending its involvement in the CMS program in light of the newly released CMS retrospective trend calculations that lowered target prices for episodes, which the company said reduces the opportunity for savings.

Ultimately it was recent policies implemented by the Center for Medicare & Medicaid Innovation affecting BPCI-A pricing that led the company to believe the program is unsustainable. The BPCI-A pricing methodology, officials said, has changed repeatedly over the course of several years and has recently included a retrospective adjustment that Signify said is not based on publicly available data.

The company added the adjustment can’t be forecasted accurately and is only known long after a performance period has ended, rendering it near-impossible to “take real-time action.”

“The Company is currently in the process of contesting the most recent pricing calculations through CMMI’s standard appeals process and advocating for CMMI to offer providers immediate relief,” Signify said.

Signify said this strategy allows the company to invest more in future growth and diversification of its Home and Community Services business and its recent acquisition of…

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