The CMS Transforming Episode Accountability Model: 4 reasons why it’s an opportunity for skilled nursing facilities to partner with hospitals—and 3 steps for developing a TEAM strategy

Garrett SchmittNo Comments

On January 1, 2026, approximately 700 hospitals across the United States began mandatory participation in the Centers for Medicare & Medicaid Services’ (CMS’) Transforming Episode Accountability Model (TEAM). TEAM is CMS’ new bundled payment model where participants will be taking on financial risk for the costs and quality outcomes of Medicare fee-for-service (FFS) beneficiaries undergoing…

Medicare Advantage members in value-based care see 229,000 fewer inpatient admissions: Humana

Garrett Schmitt,

Humana saw a 24.3% decrease in inpatient admissions, or a 229,000-stay dip, for Medicare Advantage members in value-based care arrangements versus those in traditional Medicare in 2024, according to Humana’s “12th Annual Value-based Care Report,” published Feb. 4. Humana reviewed 2024 data to evaluate outcomes for its Medicare Advantage members. Seventy-one percent of Humana individual MA members…

Inside LEAD: As CMS Winds Down ACO REACH, Nursing Homes Mull Options

Garrett Schmitt,

As the Centers for Medicare and Medicaid Services (CMS) hits reset on an important value-based care initiative popular with health care providers, including nursing homes, providers will need to make considerations this spring on whether to participate in the new model called LEAD – short for Long-term Enhanced ACO Design. Starting in 2027, the federal…

ACOs Improve Primary, Preventive Care Delivery for Medicare Beneficiaries

Garrett Schmitt

Medicare beneficiaries whose physicians participate in accountable care organizations (ACOs), particularly those taking on financial risk for cost and quality, receive substantially more primary and preventive care than beneficiaries outside of these models, according to new data released by Accountable for Health (A4H). The evidence reinforces the role of value-based care structures in driving early intervention, better…

2026 Medicare ACO Initiatives: New Models, Increased Participation, and Enhanced Patient Care

Garrett Schmitt,

On February 4, the Centers for Medicare & Medicaid Services (CMS) released a fact sheet about the 2026 Medicare Accountable Care Organization (ACO) participation. As of January 2026, an estimated 14.3 million Medicare beneficiaries will receive care coordinated by ACOs, up from 13.7 million in 2025, marking a 4.4 percent increase, CMS reported. This includes patients whose…

RECORDED WEBINAR: From Prediction to Practice: Rethinking Chronic Disease Management in Value-Based Care

Garrett SchmittNo Comments, , ,

 Download Slides As healthcare organizations take on greater accountability for outcomes and cost, managing chronic disease requires more than retrospective reporting. This session examines how earlier risk identification, sustained patient engagement, and coordinated care delivery can work together to improve outcomes and reduce avoidable utilization—particularly in high-burden chronic conditions. Speakers: Reynaldo Villar, Digital Architect…

The AI leadership gap threatening value-based care

Garrett SchmittNo Comments, , , ,

The healthcare industry is at a critical inflection point and the promise of value-based care is at risk due to operational complexity and clinician burnout. AI offers a potential lifeline to streamline processes and restore focus on patient care. However, widespread adoption is stalling. Concerns around trust, transparency, and usability are slowing progress. This isn’t just…

Reengineering ACOs To Make Medicare Competitive

Garrett Schmitt

Today’s Medicare program faces familiar cost and quality challenges. Medicare Part A is projected to be insolvent in 2033 and will start drawing down funds from the Part A Trust Fund in 2028. While moderating slightly during the COVID pandemic, spending growth has increased and remains high – 8.1 percent in 2023. Medical complexity also remains a challenge, with…

RECORDED WEBINAR: Thriving Under TEAM and Building Toward CMS’s 2030 Value-Based Care Goal

Garrett SchmittNo Comments, , ,

 Download Slides As of January 1, 2026, CMS’s Transforming Episode Accountability Model (TEAM) is live – and for selected hospitals, participation is mandatory. TEAM is more than a reimbursement change. It is a readiness test for value-based care, demanding tighter financial, clinical, and operational coordination. Unlike voluntary programs such as BPCI Advanced, TEAM requires…

RECORDED WEBINAR: Reading the Future of Medicare Value-Based Care in CMS Payment Models

Garrett SchmittNo Comments, , , , , ,

 Download Slides Last year we saw a shift in the CMS Value-Based Care Program, with the announcement of two specialty care risk payment models, and the retirement of several models like Primary Care First, Making Care Primary, and alterations in Kidney Care Choices. CMS also restated its strategies for Value-Based Care, requiring the inclusion…