The AHA expressed concerns June 10 to the Centers for Medicare & Medicaid Services about its proposed Transforming Episode Accountability Model (TEAM), saying it "is proposing to mandate a model that has significant design flaws, and as proposed, places too much risk on providers with too little opportunity for reward in the form of shared savings, especially considering the significant upfront investments required." The proposed mandatory payment model would bundle payment to acute care hospitals for five types of surgical episodes, which comprise over 11% of inpatient prospective payment system payments (not including outpatient payments that would also be at risk in the model). The association urged CMS to make model participation voluntary, reduce the discount factor from 3% to no more than 1%, and make several significant changes to design elements, otherwise CMS should not implement the model. “If CMS cannot make extensive changes to the model, it should not implement it at this time,” AHA wrote. “To do so would make TEAM no more than a thinly disguised payment cut, as it fails to provide hospitals a fair opportunity to achieve enough savings to garner a reconciliation payment.”

Related News Articles

Headline
The Centers for Medicare & Medicaid Services June 30 issued its calendar year 2026 proposed rule for the home health prospective payment system. This rule…
Headline
The Centers for Medicare & Medicaid Services today announced it has identified a fraud scheme targeting Medicare providers and suppliers. CMS said scammers…
Headline
A report released June 17 by NORC at the University of Chicago, commissioned by the Coalition to Strengthen America’s Healthcare, found that patients enrolled…
Headline
The Medicare Payment Advisory Commission June 13 released its June report to Congress that outlines recommendations for hospital and other Medicare payment…
Headline
The AHA commented to the Centers for Medicare & Medicaid Services June 10 on the fiscal year 2026 inpatient prospective payment system proposed rule (https…
Headline
The AHA expressed concerns (LINK) to the Centers for Medicare & Medicaid Services today on payment updates for the fiscal year 2026 proposed rule for the…