The Center for Medicare and Medicaid Innovation (CMMI) recently released a list identifying more than 700 hospitals required to participate in the Transforming Episode Accountability Model (TEAM). Hospitals on the list need to identify a point of contact for TEAM-related communications from CMMI.
Background
TEAM begins on January 1, 2026 and runs through December 31, 2030. It creates a retrospective 30-day bundled payment for five high-volume procedures—lower extremity joint replacement (LEJR), surgical hip femur fracture treatment (SHFFT), coronary artery bypass graft (CABG), spinal fusion, and major bowel procedure—that account for approximately 15% of Medicare inpatient covered charges.1 Two of the bundles—LEJR and spinal fusion—include both inpatient and outpatient procedures, creating site-neutral prices for lower acuity cases.
The model’s target price includes almost all covered Part A and B services that occur from the date of the triggering procedure/admission through 30 days post-discharge/procedure. The target price is based on three prior years of regional spending data, incorporates patient-specific risk adjustment, and includes hospital-specific factors, trend and normalization factors, and an episode-specific discount factor to assure CMMI savings.
Next Steps
Selected hospitals have approximately 16 months to prepare. While this may seem like a long runway, it isn’t, given the complexity of re-engineering care processes across three or four distinct surgical specialties. The first step in the process for selected hospitals is a current state assessment of TEAM episode performance using Medicare claims data—which CMMI will not make available until shortly before the model begins. However, Forvis Mazars has extensive experience assisting participants in the Bundled Payment for Care Improvement Advanced (BPCI-A) and Comprehensive Care for Joint Replacement (CJR) models and has built precision financial models that can help hospitals assess current state performance and accelerate the preparation process.
More Information
Our detailed overview of the TEAM model is available here. If your hospital was selected and you have questions or need assistance conducting a TEAM current state assessment, please reach out to our professionals on the Healthcare Strategy & Finance team at Forvis Mazars.
- 1Analysis of 2022 CMS data for MS-DRG volume by hospital, data.cms.gov