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As of January 1, 2020, John Muir Health has been selected as a Bundle Payment Care Improvement (BPCI) Advanced Model Year 3 Participant for Medicare Beneficiaries.
BPCI Advanced is a voluntary bundled payment program that incentivizes hospitals and physicians to work together to improve quality and costs. The hospital takes responsibility for coordinating the care and has financial risk for the quality and cost of care. So this means, that if John Muir Health does not deliver the standard of care that Medicare targets, we will not receive additional payment for your services
A bundled payment combines, or bundles together, payments that Medicare makes to all of your health care providers for the many different kinds of medical services you might get in a specific time period. In BPCI Advanced, the bundle is activated during your hospital stay, and will include the hospitalization, and all Medicare services provided during the 90 days following discharge. This doesn’t change your Medicare rights or benefits and you don’t need to do anything. Upon discharge, you will receive a Beneficiary Notification letter with further details if you have any questions.
BPCI Advanced applies to traditional Medicare patients only (must be entitled to CMS Part A and enrolled in CMS Part B), whose admission or procedure places them in one of the selected bundles (see selected bundles below).
CMS excludes patients that are include Mine Workers, Medicare Advantage or Healthcare Prepayment, end-stage renal (ESRD), Medicare Secondary or other beneficiaries.
Bundled payments are a “value-based” initiative that holds health care providers responsible for both the quality and cost of medical care they give. Bundled payments encourage your physicians, hospitals and all providers to work together to provide better, more coordinated care during your hospital stay, post-acute care, and throughout your recovery.
John Muir Health maintains its commitment to being innovative with a focus on quality and costs, by participating in alternative payment models such as bundled payments. Participating in this model will lead to streamlined, coordinated care episodes that improve quality and the patient experience and reduce costs (defined as what Medicare pays for services).
John Muir Health has demonstrated success in similar models in the past through the Comprehensive Care for Joint Replacement (CJR) model and seeks to continue this success within BPCI Advanced.
Better coordination of care occurs when hospitals, doctors, and other health care providers work together. By working together, the health care providers within BPCI Advanced are trying to more efficiently provide well-managed, high quality, patient-centered care as you undergo treatment. Medicare will monitor your care to make sure you and others get high quality care within BPCI Advanced.
As we coordinate your care at discharge within BPCI Advanced, we have partnered with the following Skilled Nursing Facilities that meet the high standards of patient care for John Muir Health and CMS. Your care team will provide further information regarding our Preferred Skilled Nursing Facilities as well as all other Skilled Nursing Facilities if this type of care is recommended for you.
Skilled Nursing Facility |
Address |
City |
PROMEDICA Walnut Creek |
1226 Rossmoor Parkway |
Walnut Creek |
Stonebrook Healthcare Center |
4367 Concord Blvd. |
Concord |
Legacy Nursing and Rehabilitation Center |
1790 Muir Road |
Martinez |
Danville Post-Acute Rehab |
336 Diablo Road |
Danville |
Pleasant Hill Post Acute |
1625 Oak Park Blvd. |
Pleasant Hill |
Windsor Manor Rehabilitation Center of Concord |
3608 Clayton Road |
Concord |
La Casa Via Transitional Care Center |
1449 Ygnacio Valley Road |
Walnut Creek |
Moraga Post-Acute |
348 Rheem Ave |
Moraga |
Shadelands Post-Acute |
27565 Mitchell Drive |
Walnut Creek |
San Miguel Villa |
1050 San Miguel Road |
Concord |
Lone Tree Post-Acute |
4001 Lone Tree Way |
Antioch |
Tampico Terrace Care Center |
130 Tampico |
Walnut Creek |
For more information, you can: