CMS’s newly finalized TEAM payment model holds hospitals accountable for entire surgical episodes
Editor's Note As part of the Centers for Medicare and Medicaid Services (CMS) newly issued 2026 Final Rule, the Transforming Episode Accountability Model (TEAM) will hold hospitals and health systems accountable for the entire episode of care for major surgeries, from admission through 30 days post-discharge. HIT Consultant reported the…
Bad debt climbs as patient defaults, denials impact hospital revenue growth
Editor's Note Bad debt—payments hospitals expected to collect but ultimately had to write off—is increasing across hospitals as patients struggle to pay their share of healthcare costs and insurers raise the rate of claim denials, Modern Healthcare reported June 19. Citing a Kaufman Hall analysis of data from about 700…
Session: How value-based care will impact surgical services
Editor's Note Understanding the impact of value-based care on the surgical suite (VBC) will be essential for hospitals to understand as payers begin to seek partners in new payment models. In a conference session yesterday, Lauren Cricchi, associate principal, financial services at Avalere Healthcare and Katie Sullivan, senior vice president,…
Effect of private insurer bundled payment program for total joints on outcomes
Editor's Note This multi-center study led by Humana Inc, Louisville, Kentucky, finds that a bundled payment program offered by a Medicare Advantage insurer for lower extremity joint replacements was associated with reduced spending without changes in quality. A total of 23,034 lower extremity joint replacement surgical episodes (6,355 bundled, 16,679…
Bundled payments: A win-win-win approach for ASCs
Healthcare costs in the US have increased exponentially in recent years. Surgical procedures are especially costly. Cost control without sacrificing high quality care is the ultimate goal for many surgical practices and payers. Alternative practices and payment models have been explored to meet this goal. Episode-based payments, more commonly known…
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