Bundle Selection – Lessons Learned

Lessons Learned from the BPCI Bundle Selection Process – SNF Initiated Bundles

The Archway team has been on the road since early December, meeting with our Skilled Nursing Facility partners to assist with the BPCI bundle selection process.

Two major lessons learned from our most recent discussions include:

  1. 30-Day SNF initiated bundles are more attractive than 60 or 90-Day bundles
  2. SNFs with low historical length of stay should consider pursuing all 48 bundles

30-Day Bundle Length.  After talking with our SNF partners and analyzing the data, we are recommending that SNFs pursue 30 day bundles, there are several reasons for this approach:

  • Close to 85% of SNF days happen in the first 30 days, and the vast majority of the opportunity for savings in SNF bundles is realized through reducing SNF length of stay;
  • Readmissions after day 30 present more downside risk than upside opportunity;
  • 30 day bundles are much less operationally complex, requiring SNFs to follow patients for 10 or 20 days post-discharge rather than for 45+ in a 60-Day bundle;
  • SNFs are responsible for only a third of the home health costs in a 30-Day bundle when compared to a 60-day bundle.

48 Bundle Opportunity.   SNFs whose total average costs are significantly below the statewide mean should consider pursuing all 48 bundles.  There are several benefits to this approach:

  • Most SNFs have relatively low BPCI volume per bundle, but sizable overall facility volume;
  • This approach creates opportunity to realize meaningful savings and realize value for operational improvements that have already been implemented;
  • It creates a more consistent care and financial management process for all of the patients in the facility;
  • This approach is definitely not for all SNFs, but is something to think through and potentially move toward over time for SNFs with historically low costs.

If you would like help with evaluating your opportunities ahead of the January 26th bundle selection deadline please contact us at Info@Archwayha.com or 617-209-7985.

Archway Health Advisors provides full service BPCI support to dozens of providers of all types across the country.  We have sophisticated, web based claims data analytics capabilities as well as deep knowledge and experience working with providers to understand and assess their opportunities within bundled payment programs.

As always, feel free to comment on these ideas, we’re very interested in the dialogue.

Thank you,

The Archway Health Advisors Team