Investigate the role and difficulties of nursery practitioners in a private day-nursery on detecting an early sign of SEN and carrying out early intervention support for children with SEN.
Implementation of BPCI Advanced for providers that have used past BPCI models, particularly BPCI Model 3, would be less challenging than for providers who have not, due to preestablished networks and pathways for continuity of care for some clinical episodes as well as familiarity with the program.2 In addition, many providers will be interested in participating, as BPCI Advanced qualifies as an Advanced Alternative Payment Model (APM) and thus exempts participants from payment reductions under MACRA.3 BPCI Advanced is also a voluntary payment model and will see less opposition than mandatory models such as Comprehensive Care for Joint Replacement (CJR) did, but it may not generate the same level of savings as CJR has.3 The greatest challenges with BPCI Advanced will be associated with new outpatient episodes, as previous BPCI models focused solely on inpatient episodes.4 Overall, there is significant opportunity to incentivize providers to decrease costs and improve quality for some of Medicare’s most common and most expensive clinical episodes, but implementation strategies must address challenges in order to optimize the success of this VBP model. Key lessons learned in implementation from other payment models include the placement of risk on providers to increase financial savings and risk adjustment beyond the primary diagnosis; and the allowance of waivers for services not typically covered under Medicare, such as skilled nursing facility (SNF) care without 3-day hospital stay, telehealth coverage in all geographic areas; and post-discharge home visit waivers without direct physician supervision.2,4 In addition, BPCI Advanced will ensure payments are linked to quality measures, which did not happen in previous iterations of BPCI as well as utilize more specific measures for quality universally and per episode type.4 All of these will incentivize providers to maximize financial savings and to focus on improving healthcare quality for its Medicare patients. 2. In the US, the allocation of government funding for public h>GET ANSWER