With TEAM’s focus on improving surgical recoveries and costs in major hospital-based surgeries, it’s easy to miss the importance of primary care physicians. But their role is essential for meeting TEAM’s objective to improve patient recovery and lower costs in the five major types of surgery covered by TEAM. And perhaps not in the way…
When the Centers for Medicare & Medicaid Services (CMS) launched the Transforming Episode Accountability Model (TEAM) and the AIM for Health Equity and Accountable Care Growth (AHEAD) model, it wasn’t tinkering with policy at the margins — it was redefining what hospitals are accountable for. The new rules make one truth unavoidable: the hospital’s responsibility doesn’t…
Modern medicine is more advanced than ever, yet clinical care still leans heavily on what is, in practice, informed guesswork. Doctors make the most probable diagnosis, select the therapy most likely to help, and adjust only when outcomes fall short. To further complicate matters, one-half of patients with chronic diseases do not take their medications as…
You cannot control CMS raising cut points. But you can control how you respond. Changes are happening to how Medicare Advantage plans are measured for medication adherence. Starting in measurement year 2026, CMS is introducing sociodemographic status (SDS) risk adjustment into the three Part D adherence measures: diabetes medications, RAS antagonists, and statins. What’s Actually…
The new Transforming Episode Accountability Model (TEAM) targets the highest cost or volume surgeries in the Medicare program. While hospitals bear the financial risk, CMS has created a vehicle to align interests with other providers through Collaboration Agreements that can include financial incentives. How those are structured will be key to the successful alignment—or fracture—of the hospital’s…
Download Slides Most care teams receive ADT feeds that are incomplete, delayed, and missing critical context — making it difficult to know how and when to act. This webinar focuses on how to overcome incomplete ADT feeds and determine how and when to engage high-risk members. Leaders from Avery Telehealth and Connective Health will…
The CMS target year for value-based care is 2030, with a goal for 100% of Traditional Medicare beneficiaries and the majority of Medicaid beneficiaries to be in an accountable care relationship, focusing on quality outcomes and cost efficiency over service volume. 2025 reports and surveys showed a clear turning point for value-based care as model…
Enhanced ACA premium tax credits expire Dec. 31, leaving millions of marketplace enrollees facing higher premiums in 2026. Congressional efforts to extend the subsidies have stalled, with neither a Democratic three-year extension proposal nor a Republican alternative focused on HSAs passing the Senate. A House vote on extending the subsidies could still happen in early…
CMS has announced the launch of its newest accountable care organization model with the goal of providing a better way for primary care physicians and specialists to collaborate more closely to deliver coordinated care for patients, the American Medical Association reported Dec. 22. Here are five things to know about the new program: 1. The “Long-term Enhanced…
Bundled payments are increasingly used worldwide, yet long-term evidence remains limited, particularly in maternity care. This study evaluated five-year changes after bundled payments in maternity care in the Netherlands. Using a difference-in-differences design and 2008–21 nationwide data, we compared 22,307 pregnancies across six regions that adopted bundled payments in 2017 with 69,496 pregnancies in twenty…