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The “alphabet soup” of new value-based care models from the Centers for Medicare & Medicaid Services (CMS) can be confusing and overwhelming for nursing home operators, but there are two models that should be on every provider’s menu: the Long-Term Enhanced ACO Design (LEAD) model and Transforming Episode Accountability Model (TEAM).
Brian Fuller, managing director of value-based care design and delivery for ATI Advisory, said the TEAM model is high on his list for potential participation by nursing homes, despite hospitals not having the expected level of receptiveness and readiness with the model.
“We anticipate that will change on Jan. 1, 2027, which is when hospitals are subjected to financial downside risk,” said Fuller. “They are taking on risk this year, but it is upside only.”
Fuller expects more accountable care organization (ACO) models from CMS as well, possibly with the Innovation Center launching a framework that resembles the Program of All-Inclusive Care for the Elderly (PACE)
“I do think it will intersect with a lot of [nursing home operators], so things like dual eligible models, complex care models,” said Fuller.