Surgery will be a financial winner or loser under TEAM (Transforming Episode Accountability Model), a mandatory episodic payment model beginning in January 2026. Let’s be clear: TEAM requires a tectonic plate shift in managing cost and outcomes of surgical procedures for five types of procedures. To be on the winning side of this model, your hospital…

Heads up! CMS’s Proposed 2026 PFS Rule introduces a new payment model for tackling specialty care and costs in traditional Medicare. Clearly not a snap decision, Ambulatory Specialty Model (ASM) has been cooked until well-seasoned and served up in 210 pages of the proposed Rule. Unlike a typical Notice from the CMS Innovation Center that initiates many Value-Based Care…

As the US healthcare system speeds up its pivot from volume to value, one crucial tool, which is often overlooked in mainstream discourse, is slowly but surely going through a necessary shift—the current procedure terminology, CPT code set. Developed as well as maintained by the American Medical Association (AMA), the CPT code set has long…

Summer is here, and the heat is on: barbeques, beaches, and the 2026 CMS Physician Fee Schedule Proposed Rule. Throughout 1,803 pages, CMS is going after the total cost of care in the MIPS and APM tracks of the Quality Payment Program (QPP). These proposed updates and the creation of a surprise new (and mandatory!) Alternate Payment…