The BCMP is here to help you manage your healthcare.
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Find Your Regional Beneficiary and Family Centered Care
Quality Improvement Organization (BFCC QIO) here
On September 20, 2019, Provider Resources, Inc. (PRI) was notified by the Centers for Medicare & Medicaid Services (CMS) that we had been awarded the Beneficiary Care Management Program (BCMP) task order under CMS' Beneficiary and Family Centered Care Quality Improvement Organization Indefinite Delivery Indefinite Quantity (BFCC QIO IDIQ) contract. The BCMP contract is national in scope and covers the United States and its territories. The purpose of the BCMP is to address care management issues for Medicare Fee-for Service (FFS) beneficiaries with complex healthcare needs and limited knowledge of available resources.
Additionally, the BCMP has an ultimate goal of reducing high cost healthcare utilization such as hospital readmissions and emergency room visits. Beneficiaries and/or their family members are referred to the program by the regional BFCC QIOs at any time during their BIPA and/or Weichardt Appeal. PRI is charged with the responsibility of ensuring proper discharge planning which may include: review of discharge instructions and post-treatment plan with the beneficiary, family, and/or caregiver; coordination of follow-up care with primary care physicians and/or other providers; and referral to community resources or person and family engagement (PFE) partners. Assistance with healthcare navigation aims to promote timely and appropriate movement of an individual beneficiary across the various segments of the care continuum. It involves ensuring adequate information exchange and care coordination between providers as beneficiaries go through transitions of care.
While the concept for the program has been pilot tested on a limited basis, PRI has the honor of implementing the BCMP for CMS using our proposed approach of establishing a first-hand intervention for beneficiaries and developing a robust navigation network across the country. The success of the BCMP is important to CMS and to PRI as it promotes the integration of person-centered care and PFE values into clinical practice and beneficiary services. PRI selected KEPRO, another BFCC QIO, to serve as our subcontractor. KEPRO has been involved with the QIO program since 1985.
To learn more about PRI and our mission to instill integrity into the healthcare system, visit our corporate website. For more information on PRI as a BFCC QIO, visit our QIO website, where you can learn about our BFCC QIO Governing Board of Directors.