Podnosis New mandatory bundled payment model for hospitals
Aug 7, 2024
In this discussion, Brian Fuller, Managing Director at ATI Advisory, shares insights on the Transforming Episode Accountability Model (TEAM). He delves into how this mandatory bundled payment model will affect hospitals handling five common procedures. Brian addresses the challenges hospitals face, such as managing clinical risks and enhancing patient care. He also emphasizes the importance of collaboration among healthcare providers and learning from past payment models to succeed under this new financial framework.
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Overview of TEAM Model
- The TEAM model is a new mandatory bundled payment program covering five high-cost, high-volume procedures across most hospitals.
- It aims to incentivize better coordination during and after surgery through episode-based payments.
Broad Hospital Selection
- TEAM will select roughly 25% of hospitals nationwide, including safety nets and small rural hospitals.
- Only Maryland hospitals and those with no qualifying episodes in their area are excluded.
Selected Procedures in TEAM
- TEAM covers five procedures: CABG, major bowel surgery, surgical hip/femur fracture, lower extremity joint replacement, and spinal fusion.
- These were chosen as the highest cost and volume Medicare procedures.