(Aug. 16, 2024) – The Centers for Medicare & Medicaid Services announced the selection of five Kansas hospitals, and hundreds of hospitals nationally, for mandatory participation in a new episode-based payment model, the Transforming Episode Accountability Model.
As part of the fiscal year 2025 Inpatient Prospective Payment System Final Rule, the TEAM model aims to improve beneficiary care and reduce costs through financial accountability for episode categories that begin with one of the following procedures: coronary artery bypass graft surgery, lower extremity joint replacement, major bowel procedure, surgical hip/femur fracture treatment or spinal fusion.
Each episode will begin with an anchor hospitalization or procedure and end 30 days after discharge. TEAM will test whether financial accountability for these episode categories reduces Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries. If the model is successful, CMS intends to establish a framework for managing episodes as standard practice in Traditional Medicare. TEAM begins on Jan. 1, 2026, and will be conducted for five years.
The five Kansas hospitals selected for participation are:
- HaysMed, Hays
- Hutchinson Regional Medical Center, Hutchinson
- LMH Health, Lawrence
- The University of Kansas Health System, Great Bend
- Summit Surgical, Hutchinson
KHA is following this model closely and has connected with the participating hospitals. Non-participant members will soon receive additional information. If you have questions, please contact Jaron Caffrey at (785) 233-7436.
--Jaron Caffrey