CMS Introduced the Transforming Episode Accountability Model (TEAM) model. The proposed mandatory TEAM model would begin on January 1, 2026, and end on December 31, 2030 and signifies a significant shift towards value-based care and patient-centric models. What exactly is the TEAM model, and why is it generating buzz across the healthcare landscape? 1. Episode-Based Alternative Payment Model: TEAM represents a bold step towards episode-based alternative payment models. It builds upon the successes and lessons learned from previous models like the Bundled Payment for Care Improvement Advanced (BPCI-A) and Comprehensive Care for Joint Replacement (CJR) models. 2. Incentivizing Care Coordination: TEAM aims to incentivize care coordination, improve patient transitions, and reduce avoidable readmissions for beneficiaries undergoing specific procedures. By holding hospitals accountable for the cost and quality of care throughout the episode, TEAM promotes efficiency and quality across the care continuum. 3. Participation and Episodes: Under the proposed model, participation would be mandatory for acute care hospitals within selected core-based statistical areas (CBSAs). Episodes would cover a range of procedures, including lower extremity joint replacement, spinal fusion, and major bowel procedures, starting from hospitalization to 30 days post-discharge. 4. Economic Framework: CMS will establish target prices covering most Medicare Parts A and B spending during episodes. Hospitals will be reimbursed based on their performance compared to these targets, with adjustments for patient risk factors. 5. Participation Tracks: TEAM offers three tracks with varying levels of financial risk and quality performance adjustments, accommodating different hospital types and preferences. 6. Flexibilities and Initiatives: To support care coordination and innovation, CMS proposes flexibilities such as safe harbors for financial arrangements and beneficiary incentives. Additionally, TEAM includes a pioneering Decarbonization and Resilience Initiative, emphasizing climate resilience and sustainability. #CMS Centers for Medicare & Medicaid Services #HealthcareInnovation #ValueBasedCare #TEAMModel #PatientCentricity #HealthcareTransformation
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The Centers for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler testified before the House Committee on Energy and Commerce Health Subcommittee on CMMI’s work to advance value-based care. CMMI has seen success over the last decade, improving patient health and generating millions in savings. Members of the Alliance for Value-Based Patient Care shared recommendations to further strengthen CMMI and support long-term healthcare transformation, including: ➡️Creating new models to engage more medical specialties ➡️Making it easier for safety net, rural, and small practices to transition to value ➡️Broadening and clearly defining the criteria to expand value-based models ➡️Engaging diverse healthcare stakeholders in model development Read the full letter: https://bit.ly/45n0PZX #ValueBasedCare #CMMI #HealthcareInnovation
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Care Management is the cornerstone of effective Value-Based Care (VBC) programs, playing a crucial role in improving patient outcomes while controlling healthcare costs. Chronic Care Management (#CCM) stands out as a vital component, providing continuous, comprehensive care for patients with multiple #ChronicConditions. This proactive approach ensures that patients receive the necessary support to manage their health between office visits, reducing hospital admissions and enhancing quality of life. Currently, CCM is integrated into many healthcare practices, particularly those serving Medicare beneficiaries. The Centers for Medicare & Medicaid Services (CMS) recognizes the value of CCM and has incorporated it into several payment models, emphasizing the need for regular, non-face-to-face patient interactions. These interactions, managed by skilled #NurseCareManagers, include medication reviews, care coordination, and personalized care plans, all tailored to meet individual patient needs. The evolution of CCM is evident in its inclusion in new, innovative care models from #CMS. These models incentivize #PrimaryCarePractices to adopt a patient-centric approach, with CCM at the core, focusing on preventive care and chronic disease management. The recent introduction of the Principal Illness Navigation (PIN) services in the 2024 Physician Fee Schedule underlines the commitment to integrating care management into VBC programs. PIN services is designed to support patients with complex health needs and aligns perfectly with the goals of CCM, ensuring comprehensive care across the healthcare continuum. As we move towards a more integrated and patient-centered healthcare system, the role of #CareManagement, particularly CCM, will continue to expand. By fostering collaboration between care managers, physicians, and patients, we can achieve better health outcomes, enhanced patient satisfaction, and more efficient use of healthcare resources. Embracing CCM within VBC models is not just a strategic choice but a necessary step towards sustainable, high-quality healthcare for all. #nurseentrepreneur #valuebasedcare #nurseinnovation
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Optimizing Client Outcomes through Staff Augmentation for Case Management, Utilization Management & Social Work | Empowering Clients with Innovative Advisory Solutions
Thank you CMS for a good Monday morning read with my cup of tea 🌞 Introducing the Transforming Episode Accountability Model (TEAM), a proposed initiative aimed at enhancing care quality and reducing costs for Traditional Medicare beneficiaries undergoing surgical procedures. TEAM fosters coordinated, high-quality care, potentially lowering rehospitalization rates and improving recovery times. 🌟Key highlights🌟 🔸TEAM builds upon previous episode-based payment models and targets specific high-expenditure, high-volume surgeries. 🔸Hospitals selected would be accountable for episode quality and cost, ensuring patient referrals to primary care services. 🔸Mandatory implementation begins January 2026, spanning five years with various risk-reward tracks. 🔸Evaluation will gauge impact on care quality, access, utilization, expenditure, and patient experience. 🔸Hospitals required to participate would be based on selected geographic regions, Core-Based Statistical Areas (CBSAs) 🔸TEAM prioritizes health equity, offering flexibilities for underserved hospitals and including a social risk adjustment in pricing methodology. Exciting times ahead as TEAM aims to revolutionize Medicare care delivery! Personally, I feel inspired seeing healthcare shift more towards this value base care approach. Anyone else? Share your thoughts below 💭 Shoutout to Patricia (Patty) Resnik, MJ, MBA, FACHE, RRT, CPHQ, CHC, CHPC for always keeping me in the loop on CMS updates ⚡Link to CMS briefing in comment below⚡ #Medicare #HealthcareInnovation #ValueBasedCare #TEAMInitiative
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Value-based care priorities are becoming more accessible within a fee-for-service payment framework. Earlier this month, Centers for Medicare & Medicaid Services released the CY 2025 Medicare Physician Fee Schedule proposed rule. Town Hall Ventures is excited to dive into what this means for the future of value-based care. Andy Slavitt and Andie Steinberg explore how the new initiatives can benefit your practice, improve patient outcomes, and drive innovation in healthcare. Read the full article here: https://lnkd.in/eKpC6Nuv
Mainstreaming Value-Based Care — Town Hall Ventures
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It's crucial to pay attention to the signals behind the latest healthcare policy efforts by Centers for Medicare & Medicaid Services. The CY 2025 Medicare Physician Fee Schedule proposed rule is paving the way for a more inclusive and effective healthcare system. Check out our piece below - Andie Steinberg and I dive into new opportunities and implications for physicians, innovators, founders, and, most importantly, patients.
Value-based care priorities are becoming more accessible within a fee-for-service payment framework. Earlier this month, Centers for Medicare & Medicaid Services released the CY 2025 Medicare Physician Fee Schedule proposed rule. Town Hall Ventures is excited to dive into what this means for the future of value-based care. Andy Slavitt and Andie Steinberg explore how the new initiatives can benefit your practice, improve patient outcomes, and drive innovation in healthcare. Read the full article here: https://lnkd.in/eKpC6Nuv
Mainstreaming Value-Based Care — Town Hall Ventures
townhallventures.com
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Elizabeth Fowler, Sarah Fogler, Claire Schreiber, Brian Waldersen, Genevieve Kehoe, Rachel Roiland, Sacha Wolf, Anna Goldman, and Purva Rawal from the Centers for Medicare & Medicaid Services discuss how the CMS Innovation Center has laid out a comprehensive specialty strategy to test models and innovations that support access to high-quality, integrated specialty care across the patient journey. "The first element of the Innovation Center’s specialty strategy aims to deliver enhanced specialty care data to clinicians, hospitals, and other health care entities across multiple models and programs. This requires a coordinated rollout of multiple data initiatives to support different kinds of providers and/or participants. The framework for data coordination and transparency is based on a survey of Accountable Care Organizations (ACOs) and advanced primary care model participants that asked what additional data would support specialty care engagement." Read the full article here: https://bit.ly/43LvZJN
The CMS Innovation Center’s Strategy To Support Person-Centered, Value-Based Specialty Care: 2024 Update | Health Affairs Forefront
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How do SNFs make sense of patient data for better care? With claims-based data, we track a patient's journey after leaving the #SNF. MDS-based data, on the other hand, gives us a detailed look at their clinical care while inside. Centers for Medicare & Medicaid Services shows us both sides to help SNFs enhance care quality. Tap the link below for Net Health's take on navigating these crucial data points for superior patient outcomes. #HealthcareData 🔴 🔗: https://lnkd.in/eg4kt5d4
Understanding Claims-Based and MDS-Based Data for SNFs - Net Health
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Ever wondered how data shapes patient care in skilled nursing facilities? Dive into our latest blog to see how CMS data, from claims to clinical assessments, plays a crucial role in enhancing healthcare quality. A must-read for anyone passionate about making a difference in patient outcomes. Check out the insights in Net Health's new blog
How do SNFs make sense of patient data for better care? With claims-based data, we track a patient's journey after leaving the #SNF. MDS-based data, on the other hand, gives us a detailed look at their clinical care while inside. Centers for Medicare & Medicaid Services shows us both sides to help SNFs enhance care quality. Tap the link below for Net Health's take on navigating these crucial data points for superior patient outcomes. #HealthcareData 🔴 🔗: https://lnkd.in/eg4kt5d4
Understanding Claims-Based and MDS-Based Data for SNFs - Net Health
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Ever wondered how data shapes patient care in skilled nursing facilities? Dive into our latest blog to see how CMS data, from claims to clinical assessments, plays a crucial role in enhancing healthcare quality. A must-read for anyone passionate about making a difference in patient outcomes. Check out the insights in Net Health's new blog
How do SNFs make sense of patient data for better care? With claims-based data, we track a patient's journey after leaving the #SNF. MDS-based data, on the other hand, gives us a detailed look at their clinical care while inside. Centers for Medicare & Medicaid Services shows us both sides to help SNFs enhance care quality. Tap the link below for Net Health's take on navigating these crucial data points for superior patient outcomes. #HealthcareData 🔴 🔗: https://lnkd.in/eg4kt5d4
Understanding Claims-Based and MDS-Based Data for SNFs - Net Health
https://www.nethealth.com
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Defense Department Notices (1/3) Publication Date: 11/22/2023 Comments Close: 1/22/2024 Agency Information Collection Activities; Proposals, Submissions, and Approvals (1/3) TRICARE Inpatient Satisfaction Survey (TRISS); OMB Control Number: 0720–TRSS. FRDoc#:2023-25811 FRDoc@88 FR 81372 Agency/Docket ID: DoD-2023-HA-0116 ACTION: 60-Day information collection notice. SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the Defense Health Agency (DHA) announces a proposed public information collection & seeks public comment on the provisions thereof. Comments are invited on: whether the proposed collection of information is necessary for the proper performance of the functions of the agency, including whether the information shall have practical utility; the accuracy of the agency's estimate of the burden of the proposed information collection; ways to enhance the quality, utility, and clarity of the information to be collected; and ways to minimize the burden of the information collection on respondents, including through the use of automated collection techniques or other forms of information technology. SUPPLEMENTARY INFORMATION: ... Needs and Uses: The DHA administers the TRICARE TRISS survey to understand perceptions of inpatient care among Military Health System (MHS) users. The survey instrument adheres to the methodological and analytical protocols and questionnaire items mandated by the industry standard Hospital Consumer Assessment of Healthcare Providers and Systems protocol. Developed by the Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality, the program provides valid and reliable self-reported experience ratings of inpatient experiences. As a result, the TRISS program allows objective & meaningful comparisons between hospitals, in areas that are important to consumers. Results are published online, and the public can view them at https://www.medicare.gov/care-compare/. But perhaps most significantly, the comparative scores and findings can be used by MHS leadership to improve care as well as by beneficiaries to make informed choices. TRISS is designed to provide actionable performance feedback to improve overall quality of health care. ... https://lnkd.in/eekBKRjQ
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