If TEAM has your hospital searching for an evidence-based toolkit to improve surgical outcomes and reduce recovery time, participating hospitals and their surgical teams should pay heed to ERAS (Enhanced Recovery After Surgery) protocols. The guidelines are tailored to more than twenty types of surgery as well as anesthesia and intensive care. They have been […]
TIPS for TEAM: How to Reduce the Top Driver of Higher Variable Costs in Surgery Episodes
One of the largest and most significant changes to specialty care payments in Medicare commences in January. TEAM (Transforming Episode Accountability Model) is poised to put hospitals at risk for total costs of care for the highest cost Medicare surgical episodes, including Coronary Artery Bypass Graft (CABG), Lower Extremity Joint Replacements (LEJR), major bowel procedures, […]
Is Your ACO at Risk of Not Meeting APP Quality Reporting Standards?
Do you have confidence in your ACO’s ability to meet APP Quality Reporting requirements? The 2025 Performance Year is the first year ACOs are required to report through the APM Performance Pathway (APP). Your ACO must transition to a proven technology-based solution to be successful. You need to be well along the path to successful […]
Three Strategies for ACOs to Optimize Specialty Care through TEAM
Both the greatest strength and weakness of the ACO shared savings (MSSP) model is its focus on primary care, particularly chronic disease. ACOs have put patients with diabetes, hypertension, and other conditions usually handled through primary care physicians at the center of care coordination, population health, and care management. But as CMS Value-Based Care’s central […]
Providers: Collaborate or Lose Under TEAM Risk-Based Payment for Specialty Procedures
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 […]
CMS is Demanding Change in Specialty Care: 5 Things to Know about ASM
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 […]
Roji Health Intelligence Response to CMS RFI for Health Technology Ecosystem
Data and technology, once simply functional assets to facilitate health care, are now a leading force for health care advancement, improvement of health care outcomes, and control of costs. Yet the panoply of technologies has not optimized information for one key actor: the patient. The Center for Medicare and Medicaid Services (CMS) is attempting to […]
Let’s Put an End to What Blocks Providers and Patients from Controlling Health Care Costs
We often blame providers for not controlling health care costs. We also put the onus on patients who overuse care inappropriately and make bad choices. But the fact is that control of health care costs is extremely complicated, and we have effectively blocked both providers and patients from controlling health care costs. Since the birth […]
Multi-Payer VBC Strategy Is Essential for Cost Control, but Providers Must Get a Fair Deal
To meet its goals of controlling costs and improving patient care, Value-Based Care requires a near-universal, multi-payer strategy.
5 Things I Learned from Speaking at the Spring Managed Care Forum
One of my favorite professional activities is to speak to a broad health care audience and get feedback on their response to reform initiatives. Last week I spoke at the Spring Managed Care Forum in Orlando, Florida. The Fall and Spring forums are a favorite venue for me, and I never fail to get new […]