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In the Know with BPCI Advanced May 29, 2024 Edition

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*In The Know with BPCI Advanced*






*May 29, 2024*




*Issue No. 49*






*Table of Contents*
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* Review of TEAM, a recently proposed initiative [ #review ]
* Shifting Towards Quality Focused Healthcare [ #stqfh ]
* Stay in Touch [ #stay ]



*Review of TEAM, a recently proposed initiative*
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In the last iteration of the BPCI Advanced "In the Know" bulletin, we introduced you to the proposed mandatory Transforming Episode Accountability Model (TEAM). This proposed model was announced on April 10, 2024 as part of the FY 2025 Inpatient and Long-Term Care Hospital Prospective Payment Systems Rule (FY2025 IPPS/LTCH PPS Rule).






As proposed, TEAM would incentivize care coordination for Medicare beneficiaries undergoing specific surgical procedures in a hospital or hospital outpatient departments, as well as the services provided during the 30 days that follow. Additionally, TEAM would require referral to primary care services to support continuity of care and drive positive long-term health outcomes. This proposed model would complement other CMS value-based care initiatives by promoting the goal of having all Medicare beneficiaries in an accountable care relationship by 2030.

 

TEAM is part of the FY 2025 Inpatient and Long-Term Care Hospital Prospective Payment Systems Rule.  The proposed rule can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/2024-07567/medicare-and-medicaid-programs-and-the-childrens-health-insurance-program-hospital-inpatient. The comment period for TEAM will close on June 10, 2024.






Shifting Towards Quality-Focused Healthcare
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Tips and best practices for providers transitioning from fee-for-service to value-based care models like BPCI Advanced or TEAM.

Transitioning from a fee-for-service payment model to a value-based care model requires providers to adapt their practices, workflows, and mindset to succeed in a new healthcare environment. Here's some tips for organizations preparing for this transition:

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* Understanding the Shift: Providers transitioning to value-based care models need to understand the fundamental differences between fee-for-service and value-based reimbursement. In fee-for-service, payment is based on the volume of services provided, while in value-based care, payment is tied to quality, outcomes, and efficiency.
* Aligning Incentives: Providers should align incentives with value-based care goals to focus on delivering high-quality, cost-effective care. This may involve restructuring compensation models, performance bonuses, and quality incentives to reward outcomes and patient satisfaction rather than volume of services.
* Care Coordination: Transitioning to value-based care requires strong care coordination among providers, specialists, and other healthcare stakeholders. Providers should establish care pathways, communication protocols, and collaborative workflows to ensure seamless care transitions and coordinated patient management.
* Data Utilization: Providers need to leverage data analytics and performance metrics to monitor and improve care quality, outcomes, and cost efficiency. Utilizing data to identify trends, gaps in care, and opportunities for improvement is essential in value-based care models.
* Patient Engagement: Engaging patients in their care and decision-making processes is crucial in value-based care. Providers should educate patients about their conditions, treatment options, and the importance of preventive care to empower them to actively participate in managing their health.
* Quality Improvement: Implementing quality improvement initiatives and evidence-based practices can help providers enhance care quality, patient safety, and outcomes in a value-based care setting. Continuous monitoring, feedback, and performance improvement are key components of transitioning to value-based care.
* Training and Education: Providers and staff should receive training and education on value-based care principles, care coordination strategies, and performance measurement techniques to successfully transition to value-based care. Continuous learning and skill development are essential in adapting to new care models.
* Collaboration and Partnerships: Building collaborative relationships with other providers, payers, community organizations, and stakeholders can support providers in transitioning to value-based care. Partnerships can facilitate care coordination, resource sharing, and population health management initiatives. By following these tips and best practices, providers can navigate the transition to value-based care models successfully and drive improvements in care quality, patient outcomes, and cost efficiency.






*BPCI Advanced Website*

Main Page [ https://innovation.cms.gov/innovation-models/bpci-advanced ] | Applicant Resources [ https://innovation.cms.gov/innovation-models/bpci-advanced/applicant-resources ] | Participant Resources [ https://innovation.cms.gov/innovation-models/bpci-advanced/participant-resources ] | Quality Measures [ https://innovation.cms.gov/innovation-models/bpci-advanced/quality-measures ]

If you have questions about BPCI Advanced, reach out to the Model Team Helpdesk at *BPCIAdvanced@cms.hhs.gov* <BPCIAdvanced@cms.hhs.gov>.

Please do not respond directly to this message as the CMS Listserv inbox is not monitored.

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