Navigating the CMS TEAM Model: What Orthopedic Leaders Need to Know Now-TEAMS Webinar Slides

TEAMS Webinar Slides

Pdf Summary

The CMS Transforming Episode Accountability Model (TEAM) is a new five-year mandatory bundled payment program starting January 1, 2026, focusing on financial accountability for total costs of defined episodes of care for traditional Medicare beneficiaries. TEAM covers five key surgical procedures: lower extremity joint replacement, spinal fusion, coronary artery bypass graft, surgical hip/femur fracture, and major bowel procedures. Episodes last 30 days post-discharge or procedure, a shorter duration compared to prior models.<br /><br />TEAM introduces three participation risk tracks for hospitals, ranging from upside-only risk to full two-sided risk, with 735 hospitals in mandatory geographic areas. Safety-net hospitals can opt for lower-risk tracks temporarily. The model includes a composite quality score based on readmission, patient safety, and patient-reported outcomes, which impacts reconciliations and financial settlements.<br /><br />Orthopedic services have a crucial role in TEAM, representing 40-60% of episodes, and bringing experience from previous bundled payment programs like CJR and BPCI. Orthopedics can leverage gainsharing opportunities, aligning incentives between surgeons and hospitals, and lead in care pathway design to improve cost and quality outcomes.<br /><br />Hospitals and private practices are encouraged to prepare early by understanding episode definitions, improving data capture and analytics on outcomes and costs, and aligning governance and care coordination efforts. Practices should clarify financial and quality metric expectations with hospitals and engage in collaborations. Hospitals must establish leadership, financial modeling, data infrastructure, and gainsharing agreements to optimize TEAM performance.<br /><br />Different organizational approaches to TEAM participation include hospital-led, physician-aligned models; physician-led with hospital support; joint governance; employment models; and contractual alignments, each suiting different hospital-physician dynamics.<br /><br />In summary, TEAM represents a strategic shift to episode-based payment with greater financial accountability and quality focus, especially significant for orthopedic leaders to guide care innovation and achieve value under Medicare payment reform.

Keywords

CMS TEAM program

bundled payment

episode accountability

Medicare beneficiaries

surgical procedures

risk tracks

composite quality score

orthopedic services

gainsharing opportunities

care coordination