What's Happening?
On January 1, the Centers for Medicare & Medicaid Services (CMS) introduced the Transforming Episode Accountability Model (TEAM), a new mandatory alternative payment model. This initiative requires numerous
acute care hospitals to engage in episode-based payments for five common, high-cost surgeries. The TEAM model aims to enhance the quality of care while reducing Medicare expenditures. Despite its goals, the model has faced criticism from the healthcare industry, particularly from smaller hospitals that argue the mandatory nature of the program could pose financial risks. CMS defends the model, stating it builds on previous voluntary programs and aligns with federal recommendations. Jeff Gleason, M.D., the chief medical officer of Navvis, a value-based care enablement company, emphasizes the importance of hospitals preparing for this shift to avoid future challenges.
Why It's Important?
The introduction of the TEAM model is significant as it represents a shift towards value-based care, which focuses on improving patient outcomes while controlling costs. This model could potentially lead to substantial savings for Medicare, estimated at $750 million. However, the mandatory nature of the program raises concerns about the financial viability of smaller hospitals, which may lack the resources to adapt quickly. The success of the TEAM model could influence future healthcare policies and payment models, potentially setting a precedent for mandatory participation in value-based care initiatives. Stakeholders in the healthcare industry, including hospitals and policymakers, will need to navigate these changes carefully to balance cost savings with the quality of patient care.
What's Next?
As the TEAM model is implemented, hospitals will need to adjust their operations to comply with the new payment structure. This may involve investing in new technologies and processes to track and manage episode-based payments effectively. The healthcare industry will likely monitor the outcomes of the TEAM model closely to assess its impact on both cost savings and patient care quality. Feedback from participating hospitals could lead to adjustments in the program, potentially influencing future healthcare policy decisions. Additionally, the response from smaller hospitals and their ability to adapt will be critical in determining the model's overall success and sustainability.
