In a healthcare system already stretched skinny by rising prices, workers burnout, and fragmented post-acute care, the Facilities for Medicare & Medicaid Providers (CMS) is upping the ante.
Starting January 1, 2026, the Remodeling Episode Accountability Mannequin (TEAM) will develop into obligatory for hospitals in 797 core-based statistical areas (CBSAs) throughout the U.S.
This isn’t one other pilot or voluntary different fee mannequin. It’s the most recent in a sequence of CMS efforts to tie reimbursement to worth. This time hospitals and their care companions can be held accountable for the entire price and high quality of care all through an episode.
Regardless of its scope and implications, TEAM has flown considerably beneath the radar. However with 2026 only a few quick months away, now could be the time for training, planning, and partnership.
What Is the TEAM Mannequin?
TEAM is a five-year obligatory bundled fee mannequin targeted on 5 surgical episodes:
- Decrease extremity joint substitute (LEJR)
- Surgical hip and femur fracture therapy
- Spinal fusion
- Coronary artery bypass graft (CABG)
- Main bowel procedures
Hospitals in chosen CBSAs can be held financially answerable for all Medicare Half A and B prices related to these procedures – from the preliminary hospital keep by means of 30 days post-discharge. That features expert nursing, rehab, house well being, doctor visits, and readmissions.
Relying on the participation monitor, hospitals might resist 20% draw back danger primarily based on whether or not their whole episode spending exceeds CMS’s goal worth and the way they carry out on outlined high quality measures.
Why TEAM issues
Many hospitals have expertise with bundles like BPCI Superior and CJR, however TEAM provides complexity by tightening the timeline and deepening accountability. It additionally introduces new expectations round major care referrals, fairness reporting, and post-discharge care coordination.
Hospitals that don’t put together danger falling behind – not solely financially, however operationally and clinically. Fortuitously, there are clear actions well being techniques can take now to set themselves up for achievement.
1. Perceive your episode danger
Hospitals ought to start by analyzing their historic efficiency throughout the 5 TEAM episodes. Which procedures drive essentially the most post-acute spend? The place are readmissions or problems highest? What’s your baseline for patient-reported outcomes?
Hospitals that participated in BPCI-A or CJR might have already got this information. Others might want to depend on inside claims evaluation or work with exterior companions to simulate potential beneficial properties and losses beneath TEAM’s pricing mannequin.
Understanding how your efficiency compares to nationwide benchmarks (and the way high quality scores are normalized) is essential for forecasting monetary publicity.
2. Map your post-acute community
Considered one of TEAM’s central goals is lowering post-acute fragmentation, notably within the transition from hospital to house. Hospitals should get a greater deal with on what occurs after discharge.
This implies mapping your referral patterns, assessing outcomes throughout post-acute suppliers, and figuring out the place the largest gaps exist. Which SNFs, house well being businesses, or rehab services are constantly delivering high quality outcomes? Which of them drive avoidable utilization or readmissions?
Take into account establishing most well-liked supplier relationships that embody information sharing and end result expectations. Briefly, deal with post-acute companions much less like distributors and extra like extensions of your care group.
3. Construct (or purchase) episode-level visibility
You possibly can’t handle what you may’t see. Success beneath TEAM will depend upon hospitals’ capacity to observe affected person progress in actual time – by means of surgical procedure, discharge, and restoration.
Hospitals ought to prioritize episode monitoring infrastructure that pulls collectively EHR information, claims exercise, and real-time affected person interactions. This contains the flexibility to flag danger components, immediate care interventions, and spot delays or deviations from care pathways.
It’s additionally essential to notice that TEAM isn’t nearly price containment. It’s about high quality.
Your system ought to seize and report on TEAM’s core high quality metrics, together with readmission charges, affected person security indicators, and patient-reported outcomes for LEJR episodes.
4. Align and practice your care groups
TEAM introduces new workflows and accountability requirements that reach past the hospital partitions. Medical and administrative groups alike should perceive:
- The scope and implications of TEAM
- Their function in documenting and delivering high-quality care all through the episode
- How major care referrals and care coordination have an effect on reimbursement
Hospitals also needs to put together discharge planners, case managers, and navigators for extra lively roles in managing sufferers by means of care transitions.
5. Don’t wait to interact companions
Lastly, whereas the primary efficiency yr contains an upside-only monitor for a lot of hospitals, that cushion will fade rapidly. Well being techniques that wait till late 2025 or early 2026 to implement modifications danger lacking the chance to course-correct.
Whether or not you accomplice with care coordination distributors and/or built-in post-acute networks, search for options that improve your inside capabilities.
Your purpose must be to create a linked, patient-centric strategy that spans scientific, monetary, and operational wants.
The way forward for fee reform
CMS has made it clear: fee reform is right here to remain. TEAM is a sign that bundled care is now not a check mattress.
For hospitals and well being techniques, the problem is steep, however so is the chance. TEAM provides a framework to ship extra coordinated, cost-effective, and patient-focused care. Those that put together now can be much better positioned to thrive in a value-based future.
When you haven’t began your readiness planning, now could be the time. TEAM is coming. Will you be prepared?
Photograph: gustavofrazao, Getty Pictures
Kyle Cooksey is Chief Govt Officer of Deacon Well being, main the corporate’s development as a value-based care platform targeted on specialty care price containment and improved affected person outcomes. With over 20 years of healthcare expertise, Kyle is a seasoned government identified for driving innovation in high-cost, high-need areas. He focuses on aligning operational methods with buyer must ship measurable outcomes. At Deacon, he’s scaling a confirmed, human-centered navigation mannequin to fulfill the increasing demand for specialty value-based care options.
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