Describe Bundled Payments for Care Improvement (BPCI) and what an "episode" includes.

• A. BPCI covers only post-acute care.
• B. BPCI pays a single price for all related care across settings for a defined clinical episode.
• C. BPCI pays per service across episodes.
• D. BPCI covers only the index hospitalization.

Answer: (C)

Bundled Payments for Care Improvement uses a single price to cover all care related to a defined clinical episode across settings. The episode typically starts with the anchor event, usually the index hospitalization for a condition or procedure, and includes all related services across the care continuum—hospital care, physician services, post-acute care such as skilled nursing or home health, and other outpatient services—during a defined post-discharge window (commonly 30, 60, or 90 days). The goal is to incentivize care coordination and cost efficiency, with providers sharing savings if total costs come in under the bundle and bearing risk if they exceed it. This isn’t limited to post-acute care, isn’t paid per service, and isn’t restricted only to the index hospitalization.