Transforming
Episode
Accountability
Model
New mandatory CMS alternative payment model for hospitals.
About the Model
The Centers for Medicare & Medicaid Services (CMS) has recently finalized a new mandatory bundled payment model called the Transforming Episode Accountability Model (TEAM). Starting in January 2026, hospitals in selected regions will be required to participate. Under this model, participating hospitals will be responsible for managing a 30-day episode of care following five specific surgical procedures: lower extremity joint replacement, surgical treatment of hip and femur fractures, spinal fusion, coronary artery bypass grafting, and major bowel procedures.
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The model aims to improve care coordination between providers during surgeries and the subsequent 30-day recovery period. As part of the TEAM model participants will be required to refer patients to primary care services supporting long term coordinated care and outcomes.
Partner for Success
Consulting services in preparation and implementation of the bundle alternative payment model.
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VHI is here to assist with operational guidance and preparation. Consulting Engagement Opportunities:
Transforming Episode Accountability Model (TEAM) Strategy Development:
- Assist hospitals in understanding and navigating the CMS's Transforming Episode Accountability Model (TEAM).
- Develop tailored strategies for managing the 30-day post-surgical episode to improve patient outcomes.
Care Coordination Optimization:
- Provide expert guidance on optimizing care coordination between providers and the subsequent recovery period.
- Implement best practices for seamless communication and collaboration among healthcare teams.
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Regional Implementation and Impact Assessment:
- Support hospitals in selected regions with mandatory TEAM model participation.
- Analyze the impact of mandatory participation and develop strategies to mitigate challenges and leverage opportunities.
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Primary Care Referral Program Development:
- Design and implement effective referral programs to connect patients with primary care services.
- Ensure ongoing care and support long-term positive health outcomes through strategic primary care integration.
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TEAM Model Implementation and Compliance Support:
- Offer step-by-step guidance on preparing for the January 2026 implementation of the TEAM model.
- Ensure compliance with CMS guidelines and regulations through customized consulting services.
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Challenge Mitigation and Opportunity Identification:
- Identify and address potential challenges hospitals may face with TEAM model implementation.
- Explore opportunities to enhance care delivery, achieve cost savings, and drive success in the TEAM model.