How The Latest Rules Might Affect Your Practice: Legislative and Regulatory Update - Including the new TEAM CMMI Program-TEAM-FactSheet_8_1

TEAM-FactSheet_8_1_24

Pdf Summary

The Transforming Episode Accountability Model (TEAM) aims to improve care quality and efficiency for Medicare beneficiaries undergoing specific surgical procedures by holding hospitals accountable for coordinating care and referring patients to primary care services. Starting in January 2026, this five-year mandatory model will involve selected hospitals across the US, with different risk and reward tracks available based on hospital type. The model focuses on episodes such as joint replacement and coronary bypass graft to reduce rehospitalization and recovery time while lowering Medicare costs. Participants will receive a target price for episodes and may earn or owe payments based on spending compared to the target. The model's goals include enhancing care quality, reducing costs, and achieving equitable outcomes by 2030. Evaluation will assess quality measures, spending, and patient experience to measure the impact of the episode-based approach. TEAM will encourage hospitals to continue episode-based care practices and foster health equity by accommodating underserved populations with lower financial risks. Overall, TEAM seeks to transform care delivery and outcomes for patients undergoing surgical procedures while promoting accountability and value-based care in the healthcare system.

Keywords

Transforming Episode Accountability Model

TEAM

Medicare beneficiaries

surgical procedures

care quality

efficiency

hospitals

target price

health equity

value-based care