Bundled Payments for Care Improvement Advanced — universally called BPCI Advanced — is the CMS Innovation Center's flagship voluntary episode-based bundled payment model and the most widely adopted Advanced APM bundled payment program in Medicare. BPCI Advanced creates 90-day clinical episodes spanning 37 inpatient and 4 outpatient clinical episode categories, holding participating hospitals, physician group practices (PGPs), and conveners accountable for total Medicare Part A and Part B spending during each episode against a risk-adjusted Target Price. For Georgia hospitals and specialty practices that have participated since the model launched October 1, 2018, BPCI Advanced has been the operational proving ground for episode-based accountable care — and the predecessor for the mandatory TEAM model that takes effect January 1, 2026.
This guide explains how BPCI Advanced works, who participates, how target prices and reconciliation operate, what BPCI Advanced means for Georgia beneficiaries and clinicians, and how BPCI Advanced relates to the broader CMMI model portfolio and the upcoming TEAM model.
The statutory and regulatory foundation
BPCI Advanced rests on:
- Section 1115A of the Social Security Act (42 U.S.C. § 1315a) — the CMS Innovation Center statutory framework, added by ACA Section 3021 (Public Law 111-148, March 23, 2010). BPCI Advanced operates under Section 1115A demonstration authority.
- Section 1833(z) SSA — Advanced APM and Qualifying APM Participant (QP) framework, added by MACRA 2015 (Public Law 114-10, April 16, 2015). BPCI Advanced is structured as an Advanced APM.
- CMMI BPCI Advanced Request for Applications (2018) — the original RFA establishing the model.
- BPCI Advanced Participation Agreements — legal contracts between CMS and each participant for each Model Year.
BPCI Advanced is not codified in 42 CFR Part 412, 413, 414, or other generally applicable Medicare regulations. The model operates through CMMI demonstration authority, with details in Participation Agreements and annual implementation guidance.
The BPCI Advanced performance period
BPCI Advanced operates over seven Model Years:
- Model Year 1: October 1, 2018 – December 31, 2018
- Model Year 2: January 1, 2019 – December 31, 2019
- Model Year 3: January 1, 2020 – December 31, 2020
- Model Year 4: January 1, 2021 – December 31, 2021
- Model Year 5: January 1, 2022 – December 31, 2022
- Model Year 6: January 1, 2023 – December 31, 2023
- Model Year 7: January 1, 2024 – December 31, 2025 (extended two-year model year)
BPCI Advanced sunsets December 31, 2025, after which the mandatory Transforming Episode Accountability Model (TEAM) takes effect January 1, 2026, in selected MSAs.
The 90-day episode structure
Each BPCI Advanced clinical episode is 90 days long, beginning with one of the following triggers:
Anchor inpatient stay (37 inpatient clinical episode categories)
- The episode begins on the date of admission to an inpatient hospital with a qualifying MS-DRG
- Episode includes the anchor inpatient stay plus all Medicare Part A and Part B spending through 90 days post-discharge
Anchor outpatient procedure (4 outpatient clinical episode categories)
- The episode begins on the date of a qualifying outpatient procedure (e.g., percutaneous coronary intervention)
- Episode includes the anchor procedure plus all Medicare Part A and Part B spending through 90 days post-procedure
The episode captures everything covered by Medicare Part A and Part B during the 90-day window:
- Anchor hospitalization
- Physician services during anchor admission
- Post-acute care (SNF, IRF, LTCH, home health)
- Readmissions
- Outpatient services (physician, hospital outpatient, lab, imaging, DME)
- Hospice services
- Part B drugs and other covered services
The 90-day window is the critical accountability frame — participants are accountable for the patient's entire Medicare experience, not just the index hospitalization.
The 41 clinical episode categories
BPCI Advanced covers 37 inpatient and 4 outpatient clinical episode categories:
Major inpatient categories
- Major Joint Replacement of the Lower Extremity (MJRLE) — hip and knee replacement (the most-volume bundle)
- Spinal Fusion — cervical, thoracic, lumbar
- Cardiac Valve Procedures — TAVR, surgical valve replacement, valve repair
- Coronary Artery Bypass Graft (CABG)
- Percutaneous Coronary Intervention (PCI) — inpatient
- Acute Myocardial Infarction (AMI)
- Congestive Heart Failure (CHF)
- Cardiac Arrhythmia
- COPD, Bronchitis, Asthma
- Pneumonia
- Sepsis
- Stroke (ischemic and hemorrhagic)
- Hip and Femur Procedures Except Major Joint
- Renal Failure
- Gastrointestinal Hemorrhage
- Gastrointestinal Obstruction
- Pancreatitis
- Cellulitis
- Diabetes / Endocrine and Metabolic Disorders
- Cervical Spinal Fusion
- Lumbar Spine Fusion (Except Pelvis)
- Combined Anterior Posterior Spinal Fusion
- Removal of Orthopedic Devices
- Disorders of the Liver Except Malignancy
- Major Cardiovascular Procedures
- Major Bowel Procedure
- Lower Extremity / Humerus Procedure Except Major Joint
- Spinal Fusion (Cervical Spine Fusion)
Outpatient categories
- Percutaneous Coronary Intervention (PCI) — outpatient
- Cardiac Defibrillator
- Back & Neck Except Spinal Fusion (outpatient)
- Radiation Therapy
The most operationally significant bundles for Georgia hospitals are MJRLE, CABG, Cardiac Valve, AMI, CHF, COPD, Sepsis, and Stroke — these are high-volume bundles with substantial financial risk and meaningful improvement opportunities.
The Target Price methodology
For each clinical episode category, CMS calculates a Target Price for each participant:
Components
- Risk-adjusted baseline spending — historical (typically 4-year baseline) average episode spending for that participant adjusted for patient mix
- Patient case-mix risk adjustment — adjustment for patient demographics, comorbidities, and clinical characteristics
- Trend factor — annual update for cost trends in the geographic area
- Discount factor (typically 2-3%) — the participant must beat the baseline by this discount before NPRA savings begin; this is CMS's share
The Target Price is the threshold against which actual episode spending is measured during reconciliation. Participants beating the Target Price earn NPRA payments; participants exceeding the Target Price owe NPRA repayments.
Net Payment Reconciliation Amount (NPRA)
The Net Payment Reconciliation Amount (NPRA) is calculated annually by comparing actual episode spending against the Target Price:
- If actual spending < Target Price → participant receives NPRA payment from CMS (positive NPRA, "earned savings")
- If actual spending > Target Price → participant owes NPRA repayment to CMS (negative NPRA, "owed losses")
NPRA cap
- NPRA is capped at ±20% of the Target Price
- Cap prevents catastrophic gains or losses
- Cap applies symmetrically (savings cap and loss cap)
Quality adjustment
- NPRA is adjusted based on participant performance on episode-specific quality measures
- Higher quality → higher savings or smaller losses
- Lower quality → smaller savings or larger losses
Risk-bearing
- NPRA two-sided risk qualifies BPCI Advanced as an Advanced APM under Section 1833(z) SSA
Who participates
BPCI Advanced has three participant types:
Acute Care Hospitals
- Participate as initiators for selected inpatient clinical episode categories
- Hospital-based BPCI Advanced participation is common
- Many Georgia hospitals have participated across various clinical episodes
Physician Group Practices (PGPs)
- Participate as initiators (typically for orthopedic, cardiology, or surgical bundles)
- Less common than hospital participation
- Georgia orthopedic and cardiology groups participate in selected bundles
Convener Participants
- Aggregate multiple "Episode Initiators" (hospitals or PGPs) into a single Convener arrangement
- Examples: Remedy Partners (acquired by Signify Health 2020), Cardinal Health, Premier
- Conveners provide analytics, infrastructure, and shared risk
- Many Georgia hospitals participate through Conveners rather than directly
Participation is voluntary, and participants can elect specific clinical episode categories and add/drop categories between Model Years.
Quality measures
BPCI Advanced measures quality on:
Hospital-wide measures
- Risk-Standardized Readmission Rate — 90-day all-cause readmission across the participant's episodes
- Advance Care Planning — frequency of advance care planning conversations
- Perioperative Care Selection of Prophylactic Antibiotic — first or second-generation cephalosporin
- Hospital-Level Risk-Standardized Complication Rate Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA)
Episode-specific measures
- Vary by clinical episode category
- Include measures like AMI-specific mortality, CABG-specific complications, etc.
Quality performance feeds into NPRA calculation as a quality adjustment.
Advanced APM status and the Quality Payment Program
BPCI Advanced is structured as an Advanced APM under Section 1833(z) SSA. It satisfies:
- CEHRT use — participants use certified electronic health record technology
- Quality measurement — BPCI Advanced quality measures comparable to MIPS
- Risk-bearing — meaningful risk via NPRA two-sided risk
Advanced APM status drives QP determination:
- PY 2024+ — payment-amount threshold 75%, patient-count threshold 50%
- Partial QP — payment-amount 50%, patient-count 35%
QP benefits:
- PY 2018-2022 — 5% APM Incentive Payment (paid PY+2)
- PY 2023 — 3.5% APM Incentive Payment
- PY 2024+ — Qualifying APM Conversion Factor differential
- MIPS exemption for QPs
Physician participants in BPCI Advanced PGPs or Conveners can achieve QP status if attribution thresholds are met. Hospital-only BPCI Advanced participation does not directly produce QP status for the participating hospital's employed physicians unless physician services flow through a BPCI Advanced PGP.
Beneficiary attribution and patient experience
BPCI Advanced beneficiaries are claims-based attributed to the participant whose anchor stay or procedure triggers the episode:
- Beneficiary admitted to a BPCI Advanced participating hospital for an MS-DRG covered by that hospital's selected clinical episode categories → automatic 90-day episode
- Beneficiary undergoes a BPCI Advanced PGP's outpatient procedure → automatic 90-day episode
Beneficiaries do not enroll, do not opt in, do not opt out, and may not even know their episode is included in BPCI Advanced. They retain all Medicare FFS rights — freedom of choice of post-acute care, freedom to see any Medicare provider, no enrollment, no cost, no benefit changes. BPCI Advanced is operationally invisible to beneficiaries.
Relationship to CJR (mandatory Atlanta MSA model)
The Comprehensive Care for Joint Replacement (CJR) Model is a separate mandatory bundled payment model focused on hip and knee replacement (MS-DRGs 469 and 470, plus knee replacement codes). CJR has operated since April 1, 2016 in 67 selected Metropolitan Statistical Areas — including the Atlanta MSA.
Key differences
| Feature | BPCI Advanced | CJR |
|---|---|---|
| Participation | Voluntary | Mandatory in selected MSAs |
| Episode duration | 90 days | 90 days |
| Clinical categories | 41 (37 inpatient + 4 outpatient) | Hip/knee replacement only |
| Advanced APM | Yes | Generally not (limited Advanced APM track) |
| Reconciliation | NPRA cap ±20% | Stop-loss / stop-gain limits |
| Target Price | Hospital-specific baseline | Hospital-specific + regional blend |
Atlanta MSA interaction
- Atlanta MSA hospitals are mandatorily in CJR for hip/knee replacement (MS-DRG 469/470)
- Atlanta MSA hospitals participating in BPCI Advanced cannot also include MJRLE under BPCI Advanced (CJR takes precedence for those episodes)
- For non-MJRLE bundles (cardiac, sepsis, stroke, etc.), Atlanta MSA hospitals can participate in BPCI Advanced
TEAM — the mandatory successor (January 1, 2026)
The Transforming Episode Accountability Model (TEAM) is the mandatory successor to BPCI Advanced, finalized in the CY 2025 IPPS Final Rule (89 FR 68986, August 28, 2024).
TEAM key features
- Mandatory for acute care hospitals in selected MSAs
- Performance Period: January 1, 2026 – December 31, 2030 (5 years)
- 5 clinical episode categories:
- Lower Extremity Joint Replacement (LEJR)
- Surgical Hip/Femur Fracture Treatment (SHFFT)
- Spinal Fusion
- Coronary Artery Bypass Graft (CABG)
- Major Bowel Procedure
- 30-day episode duration (shorter than BPCI Advanced's 90 days)
- Three tracks (similar to ACO REACH structure) with different risk levels
- Advanced APM status for selected tracks
Georgia hospitals in selected MSAs will be subject to TEAM regardless of their prior BPCI Advanced participation. The TEAM final rule lists the selected MSAs.
Georgia BPCI Advanced participation
Selected Georgia health systems and PGPs have participated in BPCI Advanced across various clinical episode categories:
Integrated health systems
- Wellstar Health System — selected bundle participation
- Emory Healthcare — selected bundle participation
- Piedmont Healthcare — selected bundle participation
- Northside Hospital System — selected bundle participation
- Grady Health System — selected participation
- Augusta University Health — selected participation
Physician group practices
- Selected Georgia orthopedic groups (often in MJRLE under Convener)
- Selected Georgia cardiology groups (CABG, AMI, PCI bundles)
- Selected surgical specialty groups
Conveners operating in Georgia
- Signify Health (formerly Remedy Partners) — major Convener
- Premier, Cardinal Health, and other specialty Conveners
Participation has varied year to year as bundles are added or dropped. Specific current participant lists are CMS-maintained; the model sunsets December 31, 2025 regardless.
14 best practices for BPCI Advanced participants
- Post-acute care optimization — most savings come from reducing post-acute spending (SNF days, IRF use, home health intensity)
- Risk stratification at admission — identify high-cost-risk episodes early and route to intensive case management
- Readmission prevention — strong transitions, follow-up appointments within 7 days, medication reconciliation
- SNF network curation — partner with preferred SNFs that align with bundle goals
- Home health integration — strong home health partners with bundle-aligned protocols
- Episode-specific clinical pathways — standardize care for each clinical episode category
- Care navigators / care managers — staff invested in 90-day episode follow-through
- Internal cost benchmarking — know your own baseline cost and where opportunities lie
- Convener analytics use — leverage Convener's data and benchmarking
- MJRLE protocols — reduce ALOS, shift to home discharge, reduce SNF days, optimize physical therapy
- CHF/COPD management — focus on medication adherence, transitions, and home health for these high-readmission bundles
- Cardiac bundle optimization — CABG and AMI bundles benefit from cardiac rehab and tight cardiology follow-up
- Sepsis bundle optimization — early identification, antibiotic stewardship, post-discharge surveillance
- Quality measure tracking — readmission rates, advance care planning, and complication rates all affect NPRA quality adjustment
14 common BPCI Advanced issues
- Post-acute spending overruns — the largest source of NPRA losses
- Readmission spikes — 90-day all-cause readmission directly drives episode spending and quality adjustment
- SNF length-of-stay drift — without active management, SNF days exceed bundle targets
- Patient acuity mix shifts — outlier episodes can drive bundle losses despite good population management
- Bundle selection misalignment — selecting bundles where the participant lacks improvement opportunity
- Convener fee structures — net NPRA after Convener fees may be lower than expected
- Target Price methodology updates — annual recalculation can shift targets unfavorably
- CJR overlap — Atlanta MSA hospitals cannot double-count MJRLE under BPCI Advanced
- PGP attribution complexity — physician attribution rules for QP determination can be confusing
- Data lag — episode reconciliation occurs months after episodes complete
- Patient transfer complications — patient transfers between hospitals can create attribution disputes
- Quality measure submission gaps — incomplete quality data hurts NPRA quality adjustment
- TEAM transition planning — hospitals must plan for TEAM mandatory participation starting January 1, 2026
- APP reporting (for non-QP physicians) — non-QP MIPS-eligible BPCI Advanced clinicians must submit APP at APM Entity level
Six worked examples — Georgia Medicare beneficiaries in BPCI Advanced
1. Fulton 70 — Atlanta hospital MJRLE bundle
A 70-year-old Atlanta beneficiary undergoes elective total hip replacement at an Atlanta hospital. Because the Atlanta MSA is in CJR (mandatory), her hip replacement falls under CJR — not BPCI Advanced. However, the hospital may simultaneously participate in BPCI Advanced for other episodes (cardiac, sepsis, etc.).
2. DeKalb 75 — DeKalb cardiac valve bundle
A 75-year-old DeKalb beneficiary undergoes surgical aortic valve replacement at a DeKalb hospital participating in BPCI Advanced for Cardiac Valve Procedures. The 90-day episode begins with admission and includes anchor stay, cardiac surgery physician fees, ICU recovery, SNF or IRF if needed, cardiac rehabilitation, and any readmissions through day 90. The hospital's bundle performance against Target Price determines NPRA.
3. Cobb 68 — Cobb COPD bundle
A 68-year-old Cobb beneficiary is admitted with COPD exacerbation at a Cobb hospital participating in BPCI Advanced for the COPD bundle. The 90-day episode includes anchor hospitalization, post-discharge pulmonary rehabilitation, home health, follow-up pulmonary visits, and any readmissions. The hospital invests in COPD discharge protocols, pulmonary rehab referrals, and tight follow-up to keep this episode under Target Price.
4. Worth County 72 — Albany sepsis bundle
A 72-year-old Worth County beneficiary is hospitalized for severe sepsis at an Albany-area hospital participating in BPCI Advanced for Sepsis. The 90-day episode includes anchor hospitalization, post-acute SNF stay, home health, follow-up infectious disease and primary care visits, and any readmissions. Post-acute care optimization and readmission prevention are the levers for bundle success.
5. Bibb 80 — Macon CHF bundle
An 80-year-old Bibb beneficiary is admitted with acute decompensated CHF at a Macon hospital participating in BPCI Advanced for CHF. The 90-day episode is dominated by post-discharge medication management, cardiac follow-up, home health, and readmission prevention. CHF is one of the highest-readmission bundles; strong post-discharge management is critical.
6. Hall 67 — Gainesville stroke bundle
A 67-year-old Hall County beneficiary is hospitalized for ischemic stroke at a Gainesville hospital participating in BPCI Advanced for Stroke. The 90-day episode includes anchor hospitalization (potentially including thrombolytic or thrombectomy treatment), inpatient rehabilitation or SNF, outpatient stroke rehab, primary care and neurology follow-up, and readmissions. Stroke rehabilitation intensity and quality determine both clinical outcomes and bundle performance.
Frequently asked questions
General BPCI Advanced questions
1. What is BPCI Advanced? BPCI Advanced is the CMS Innovation Center's voluntary 90-day episode-based bundled payment model that operates across 37 inpatient and 4 outpatient clinical episode categories. Participants are accountable for total Medicare Part A and Part B spending during each episode against a risk-adjusted Target Price.
2. Who runs BPCI Advanced? The CMS Innovation Center (CMMI) operates BPCI Advanced under Section 1115A SSA authority.
3. When does BPCI Advanced operate? October 1, 2018 through December 31, 2025 — seven Model Years.
4. What replaces BPCI Advanced after December 2025? The Transforming Episode Accountability Model (TEAM) — a mandatory bundled payment model in selected MSAs covering 5 clinical episode categories, launching January 1, 2026.
5. Does Georgia have BPCI Advanced participants? Yes — selected Georgia hospitals (Wellstar, Emory, Piedmont, Northside, others), PGPs, and Conveners participate.
Episode and payment questions
6. How long is a BPCI Advanced episode? 90 days. Episode starts on the date of the anchor inpatient admission or anchor outpatient procedure and ends 90 days post-discharge or post-procedure.
7. What does an episode include? All Medicare Part A and Part B spending during the 90-day window — anchor hospitalization, physician services, post-acute care (SNF, IRF, LTCH, home health), readmissions, outpatient services, and Part B drugs.
8. What is the Target Price? A risk-adjusted bundle-specific price calculated from the participant's historical baseline spending, trended forward and discounted by 2-3% to represent CMS's share of expected savings.
9. What is NPRA (Net Payment Reconciliation Amount)? The annual reconciliation amount comparing actual episode spending against Target Price. Positive NPRA = participant earns savings; negative NPRA = participant owes losses. NPRA is capped at ±20%.
10. Is the NPRA risk one-sided or two-sided? Two-sided — both upside (earned savings) and downside (owed losses) exposure. Two-sided risk is what qualifies BPCI Advanced as an Advanced APM.
Participant questions
11. Who can participate in BPCI Advanced? Acute care hospitals, physician group practices (PGPs), and convener participants that aggregate multiple episode initiators.
12. Is participation voluntary? Yes — BPCI Advanced is entirely voluntary. (TEAM, the successor, will be mandatory in selected MSAs starting 2026.)
13. Can participants select which bundles to include? Yes — participants elect specific clinical episode categories and can add or drop categories between Model Years.
14. What is a Convener? A Convener Participant aggregates multiple Episode Initiators (hospitals or PGPs) under a single BPCI Advanced participation arrangement. Conveners often provide analytics, infrastructure, and shared risk. Examples include Signify Health (Remedy Partners) and Premier.
Beneficiary questions
15. Do Medicare beneficiaries enroll in BPCI Advanced? No — beneficiaries do not enroll. They are claims-based attributed when their anchor stay or procedure occurs at a participating hospital or PGP.
16. Can beneficiaries opt out of BPCI Advanced? No — but BPCI Advanced is operationally invisible to beneficiaries. They retain full Medicare FFS benefits and rights.
17. Does BPCI Advanced affect beneficiary cost-sharing? No — standard Medicare Part A and Part B cost-sharing applies; BPCI Advanced does not change beneficiary cost-sharing.
18. Can beneficiaries see any provider during the 90-day episode? Yes — beneficiaries retain full Medicare FFS freedom of choice. The participant cannot restrict beneficiary choice of post-acute provider.
Advanced APM / QP questions
19. Is BPCI Advanced an Advanced APM? Yes — BPCI Advanced satisfies the three Advanced APM criteria (CEHRT, quality measurement, meaningful two-sided risk) and qualifies as an Advanced APM under Section 1833(z) SSA.
20. Can BPCI Advanced participants achieve QP status? Physician participants in PGPs or Conveners can achieve QP/Partial QP status if attribution thresholds are met. Hospital-only participation does not directly produce QP status for hospital-employed physicians.
21. What does QP status provide? MIPS exemption and APM Incentive Payment (5% PY 2018-2022, 3.5% PY 2023) or the Qualifying APM Conversion Factor differential (PY 2024+).
Relationship questions
22. How does BPCI Advanced relate to CJR? CJR is mandatory for hip/knee replacement in selected MSAs (including Atlanta MSA). BPCI Advanced is voluntary. Atlanta MSA hospitals cannot include MJRLE under BPCI Advanced (CJR takes precedence) but can include non-MJRLE bundles.
23. How does BPCI Advanced relate to MSSP / ACO REACH? A beneficiary can simultaneously be in an MSSP or ACO REACH attribution and a BPCI Advanced episode. Attribution overlap rules determine how spending is counted — generally BPCI Advanced episode spending continues to be ACO-attributable for the ACO's total cost of care.
24. What is TEAM? The Transforming Episode Accountability Model — BPCI Advanced's mandatory successor, launching January 1, 2026 in selected MSAs, covering 5 clinical episode categories with a 30-day episode duration.
25. Where can Georgia stakeholders learn more? innovation.cms.gov for BPCI Advanced and TEAM model details. QPP Service Center (1-866-288-8292) for QP/APP questions. Palmetto GBA (1-866-238-9650) for claims processing.
Contact resources
Federal Medicare resources
- Medicare (general) — 1-800-MEDICARE (1-800-633-4227)
- CMS Innovation Center — innovation.cms.gov
- QPP Service Center — 1-866-288-8292
- Palmetto GBA (Part A/B MAC Jurisdiction J) — 1-866-238-9650
Georgia state resources
- GeorgiaCares SHIP — 1-866-552-4464 (free Medicare counseling)
- 211 Georgia — 2-1-1
- Georgia Department of Community Health — dch.georgia.gov
- Georgia Aging and Disability Resource Connection — 1-866-552-4464
Beneficiary advocacy
- Medicare Rights Center — 1-800-333-4114
- Eldercare Locator — 1-800-677-1116
- Atlanta Legal Aid — 404-377-0701
- Georgia Legal Services — 1-800-498-9469
- Acentra Health QIO — 1-844-455-8708
Federal benefit administration
- Social Security Administration — 1-800-772-1213
- Benefits Coordination & Recovery Center (BCRC) — 1-855-798-2627
Provider/practice resources
- NAACOS — naacos.com
- AMA QPP resources — ama-assn.org
- Medical Association of Georgia (MAG) — mag.org
- Georgia Hospital Association — gha.org
Why BPCI Advanced matters
BPCI Advanced has been Medicare's proving ground for episode-based bundled payment accountability for seven years. By holding hospitals, PGPs, and conveners accountable for 90 days of Medicare spending across 41 clinical episode categories — and by structuring the model as an Advanced APM with two-sided risk — BPCI Advanced has demonstrated what voluntary episode-based payment can achieve. For Georgia hospitals and specialty practices that have participated, BPCI Advanced has been a vehicle for reducing post-acute care overuse, improving care coordination, and earning shared savings on well-managed episodes. As BPCI Advanced sunsets December 31, 2025 and the mandatory TEAM model takes effect January 1, 2026, the lessons learned in BPCI Advanced will directly inform how Georgia hospitals navigate the next phase of bundled payment — a phase where mandatory participation, shorter episode durations, and an evolving set of clinical episode categories will be the new operating frame.