Evaluating opportunity in the CMMI BPCI program: Comparison of PAC utilization to benchmarks

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By Bruce S. Pyenson, Kathryn V. Fitch, Michele M. Berrios, Tyler Engel | 06 August 2014

The opportunity to reduce Medicare claims cost in the Center for Medicare and Medicaid Innovation’s Bundled Payment for Care Improvement Initiative (BPCI) is typically in the post-acute care (PAC) period. Analyzing the opportunity to reduce Medicare PAC spending requires providers to adopt a payor state of mind—payor tools and approaches will be very helpful. Benchmarking to best practices is one of those tools.

Milliman has developed nationwide average and 10th-percentile benchmarks for PAC periods of 1-30, 31-60, and 61-90 days.