A year ahead of the implementation of a mandatory Medicare payment demonstration, hospitals are on the lookout for post-acute care providers that can help them prevent lost reimbursements.
The Centers for Medicare and Medicaid Services finalized the Transforming Episode Accountability Model, or TEAM, in August. It takes effect in 2026 and runs for five years. TEAM sets payments for 30-day episodes of care for lower-extremity joint replacements, femur fracture surgeries, spinal fusions, coronary artery bypass grafts and major bowel procedures.
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CMS projects TEAM will reduce spending and streamline care for routine operations, but unprepared hospitals could lose an average of $500 per episode of care compared to fee-for-service reimbursements, according to an analysis the National Association of Accountable Care Organizations' Institute for Accountable Care published last year.
Hospitals that fail to meet regional benchmarks would have to bear costs that exceed payments, just as they stand to benefit from keeping costs low.