• Quality, Coding & Documentation Committee (QCDC)

  CMS Releases FY 2025 IPPS Proposed Rule & Proposed Mandatory APM

  Posted by name on April 12, 2024 at 11:56 am

  This week, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2025 Inpatient Prospective Payment System (IPPS) proposed rule. The rule proposes a +2.6% increase to payments for inpatient Medicare services for hospitals that meet their quality and EHR reporting requirements. The proposed rule also addresses inpatient quality reporting requirements as well as some issues related to distribution of residency slots. This rule is also putting forward a mandatory model introduced, called the Transforming Episode Accountability Model (TEAM):

  The proposed Transforming Episode Accountability Model (TEAM) would be a mandatory episode-based alternative payment model in which selected acute care hospitals would coordinate care for people with Traditional Medicare who undergo one of the surgical procedures included in the model (initiate an episode) and assume responsibility for the cost and quality of care from surgery through the first 30 days after the Medicare beneficiary leaves the hospital.

  According to the separate CMS announcement on TEAM, “TEAM would initially focus on lower extremity joint replacement, surgical hip and femur fracture treatment, spinal fusion, coronary artery bypass graft, and major bowel procedure.”

  For more information:

  • FY 2025
    IPPS Proposed Rule: Link
  • CMS
    Press Release: Link
  • CMS
    Fact Sheet: Link
  • Transforming
    Episode Accountability Model (TEAM) Webpage: Link

  Hart Health will provide a summary of relevant provisions as soon as possible. Comments are due on June 10, 2024.

  Let me know if you think we should comment.

  name replied 11 months, 4 weeks ago 1 Member · 0 Replies
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