Senior Vice President, Commercial Strategy | Strategic GTM Leader | ABM | SaaS Sales Leader
CMS Introduced the Transforming Episode Accountability Model (TEAM) model. The proposed mandatory TEAM model would begin on January 1, 2026, and end on December 31, 2030 and signifies a significant shift towards value-based care and patient-centric models. What exactly is the TEAM model, and why is it generating buzz across the healthcare landscape? 1. Episode-Based Alternative Payment Model: TEAM represents a bold step towards episode-based alternative payment models. It builds upon the successes and lessons learned from previous models like the Bundled Payment for Care Improvement Advanced (BPCI-A) and Comprehensive Care for Joint Replacement (CJR) models. 2. Incentivizing Care Coordination: TEAM aims to incentivize care coordination, improve patient transitions, and reduce avoidable readmissions for beneficiaries undergoing specific procedures. By holding hospitals accountable for the cost and quality of care throughout the episode, TEAM promotes efficiency and quality across the care continuum. 3. Participation and Episodes: Under the proposed model, participation would be mandatory for acute care hospitals within selected core-based statistical areas (CBSAs). Episodes would cover a range of procedures, including lower extremity joint replacement, spinal fusion, and major bowel procedures, starting from hospitalization to 30 days post-discharge. 4. Economic Framework: CMS will establish target prices covering most Medicare Parts A and B spending during episodes. Hospitals will be reimbursed based on their performance compared to these targets, with adjustments for patient risk factors. 5. Participation Tracks: TEAM offers three tracks with varying levels of financial risk and quality performance adjustments, accommodating different hospital types and preferences. 6. Flexibilities and Initiatives: To support care coordination and innovation, CMS proposes flexibilities such as safe harbors for financial arrangements and beneficiary incentives. Additionally, TEAM includes a pioneering Decarbonization and Resilience Initiative, emphasizing climate resilience and sustainability. #CMS Centers for Medicare & Medicaid Services #HealthcareInnovation #ValueBasedCare #TEAMModel #PatientCentricity #HealthcareTransformation
