PM&R’s Role within Value-Based Rehabilitation Care

AAPM&R Stroke Rehabilitation Toolkit

Stroke remains the second leading cause of death, the third leading cause of death and disability combined, and a leading cause of institutionalization in the world. Developed by the Academy’s Innovative Payment and Practice Models (IPPM) Committee, the Stroke Rehabilitation Toolkit is a clinical and educational resource that AAPM&R members, payers, and health care systems can utilize to develop care structures and alternative payment models (APMs) to allow for the provision of high value stroke rehabilitation care.

This toolkit offers members the tools they need to develop a physiatrist-led stroke rehabilitation APM, in which clinical outcomes and patient satisfaction will improve and costs will be reduced through consistent and direct involvement of physiatry in stroke rehabilitation care across the continuum. 

Principles of APMs

The Academy understands its important role in defending physiatry in APM discussions and recognizes how critical it is for models to promote health equity, collaborative care, cost-effective clinical approaches, and long-term function of health to be successful. AAPM&R has released a set of 10 principles that outline the key elements necessary to achieving such goal. The principles will be used to help guide essential advocacy and knowledge building for our members and as a tool when demonstrating how PM&R can successfully contribute to value-based care initiatives.

AAPM&R 2022 APM Benchmark Survey Report

The Academy conducts a member survey every two years to assess the use of APMs across its membership. The survey data is used to generate ideas within innovative payment and practice models, set the Academy's advocacy agenda, and potentially develop new resources for members. Take a glance at the 2022 APM Benchmark Survey Report below. 

Transforming Episode Accountability Model

The Centers for Medicare and Medicaid Services (CMS) Innovation Center finalized a new mandatory episodic payment model beginning in calendar year (CY) 2026. Under the Transforming Episode Accountability Model (TEAM), acute care hospitals located in selected regions will be required to participate and will be held accountable for cost and quality of care for 30-day surgical episodes provided to Medicare beneficiaries related to:

• Spinal fusions
• Lower extremity joint replacements (LEJR)
• Surgical hip/femur fracture treatments (SHFFT) (excluding lower extremity joint replacement)
• Major bowel procedures
• Coronary artery bypass grafts (CABG)

Federal and State Advocacy Actions in 2025:

• The Innovative Payment & Practice Models (IPPM) committee continues to discuss PM&R involvement in perioperative initiatives. The committee was supportive of new efforts in this space.
• Your Academy submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to proposals related to the Transforming Episode Accountability Model (TEAM), a value-based care model which is scheduled to begin January 2026.
• Your Academy submitted comments to the Physician- Focused Payment Model Technical Advisory Committee (PTAC) to support their work on primary and specialty care transformation. Comments highlighted the need for financial incentives to support specialty engagement including tying financial incentives to impactful outcomes such as functional improvement. The letter also highlights the need for support of data sharing between primary and specialty care.
• AAPM&R joined a coalition letter submitted by the American Medical Association (AMA) to CMS highlighting our concerns with the Merit Based Incentive Payment System (MIPS) Value Pathways (MVPs). These comments urge CMS to improve transparency in its process, focus on true quality metrics, and create a realistic glidepath toward alternative payment models.