Published by APMConnect Sept 2026 Year one of the Transforming Episode Accountability Model is upside only. That changes in January 2027, and the health systems building TEAM programs right now are doing it against that clock. The population health team at Mass General Brigham spent this session showing APM Connect members what their program actually looks like in operation: how patients get identified, who touches them before and after surgery, and which post-acute habits ar

Published on APM Connect | August 2026 CMS has not yet posted the final list of clinicians who will be in the Ambulatory Specialty Model on January 1, 2027, 133 days from now, the ASM Participants data site still holds only the February preliminary file. But the two cost measures the model runs on are not a mystery, and they are not new. ASM's cost category uses the existing MIPS episode-based cost measures for heart failure and low back pain, and the 2026 performance-period

Published by APM Connect | August 2026

Published by APM Connect | August 2026 The FY2027 IPPS proposed changes (CMS-1849-F) are now final, and modifications include changes starting as early as October 1, 2026. For hospitals in the Transforming Episode Accountability Model (TEAM), CMS finalized nearly every proposal without modification. We've outlined what's changing and what your team should line up before the rule takes effect. The spinal fusion episode category is expanding CMS is adding three newly created MS

Published on APM Connect | August 2026 If you run an acute care hospital that performs hip and knee replacements, you need to know about CJR-X. Starting January 1, 2028, virtually every eligible acute care hospital in the country will be required to participate in a new bundled payment model for lower extremity joint replacement with immediate downside risk. This is not a voluntary pilot. It is not limited to select geographies. It is a mandatory, national, permanent program

Published on APM Connect | August 2026 The CY 2027 Medicare Physician Fee Schedule Proposed Rule, released July 16, 2026, includes some of the most consequential proposed modifications to the Medicare Shared Savings Program (MSSP) in recent years. While some changes take effect as early as January 2027, others (particularly the benchmark recalibration) will reshape the financial landscape for ACOs into the next decade. Taken together, the proposals reflect CMS's intent to s

Published on APM Connect | August 2026 On July 16, CMS released its proposed rule for the Calendar Year 2027 Medicare Physician Fee Schedule (PFS), which includes several updates to the Ambulatory Specialty Model (ASM). Now that we’ve had time to read and digest the proposals, here’s a breakdown of what ASM participants need to know. Some Cardiologists May Be Excepted from ASM Participation One of the notable structural proposals is an exception pathway for certain cardiolog

From Quality Scores to Downside Risk: What TEAM Participants Need to Do Now A recent webinar on the CMS TEAM model focused on one urgent message: care teams that understand the importance of daily coordination influences readmissions, quality scores, and financial outcomes. The webinar featured Sheela, QurHealth’s protocol-driven AI assistant built for TEAM workflows. Sheela supports post-discharge follow-up, medication access checks, recovery check-ins, appointment reminders

Members Access the Recording and Slides. If your organization has physicians participating in the Ambulatory Specialty Model (ASM), the CCA is not optional. It is one of two required Improvement Activities under the ASM, and every eligible participant, whether a cardiologist treating heart failure patients or an orthopedic surgeon managing low back pain must complete it. You don't have to figure this out alone. This is exactly why APM Connect exists. We hosted a live webinar

CMS is changing how certain cardiologists, orthopedic surgeons, neurosurgeons, pain management specialists, anesthesiologists and physical medicine and rehabilitation physicians treating Medicare patients with heart failure and low back pain are paid, and it comes with downside risk.

Patricia Resnik - TEAM 30 Access Recording and Slides A major theme throughout the discussion was the direct connection between care coordination and success in TEAM Quality Measures. Organizations that invest in structured workflows, cross-functional alignment, and proactive patient engagement are better positioned to drive performance in these measures. We also emphasized the importance of team training. High-performing organizations are those that ensure clinical, administ

Are you ready for the ASM Model? The Centers for Medicare & Medicaid Services (CMS) released a resource designed to support organizations preparing for participation in the ASM model. This ASM Participant Readiness Resource Manual provides guidance to help practices, health systems, and partners complete all the checklist items from CMS. What this means for you As CMS continues to advance value-based care through new and evolving models, readiness is critical. This guide off

Dayna Gallagher and Scott Ode - Mathematica RECORDING A must watch for tips on reviewing your data. DON'T WAIT until you receive your performance year reconciliation, it's too late and you likely can't correct errors. Ready to make sense of the TEAM data you receive from CMS? Mathematica shared best practices for analyzing bundled payment data and avoiding common pitfalls. Drawing on less ons from prior CMS models, Mathematica explained why hospitals’ internal data and calcul

Go beyond the basics to explore how leading organizations are rethinking care transitions, leveraging data, and building stronger SNF partnerships to reduce readmissions, control costs, and improve outcomes. Hear Sentara Health’s real-world strategies and PointClickCare’s insights on how smarter coordination and visibility across the continuum can help hospitals thrive under TEAM. Members access recording - RECORDING & SLIDES Hospitals are responsible for outcomes across the

By John Ossowski & Andrew Arreola Access full article Protecting Margin in CMS TEAM: A Focus on Implant & Instrumentation Strategy - Pinnacle Healthcare Consulting CMS 's Transforming Episode Accountability Model is accelerating the shift toward episode-based reimbursement, and implant strategy is becoming a defining factor in surgical margin performance. With implant and instrumentation costs embedded within a fixed episode payment, even modest variation can materially impac

→ Look up your NPI at TechyPolicy.com — the interactive tool shows your individual Part B allowed amounts, penalty exposure at each year’s rate (9% → 12%), cohort assignment, small practice designation, and organizational context. If you manage a group, the organization scorecard aggregates all ASM participants within your entity.

CMS has released the Ambulatory Specialty Model (ASM) preliminary participants dataset for the 2027 performance year starting January 1, 2027.

CMS determines ASM participant eligibility using the following criteria. A clinician must meet all four to be subject to mandatory participation in a given performance ye

ASM selection isn’t a one-time event—it’s a data-driven, multi-year process tied to historical claims and episode volume.

Because post-acute spending can reach up to 53% of total episode costs, this checklist focuses on post-acute priorities for TEAM participants.