CMS’s TEAM Mandate: How Preparation, Data, and Provider Networks Shape Success — Insights from AJMC
- APMConnect
- Mar 24
- 3 min read
Great article on TEAM.
The Transforming Episode Accountability Model (TEAM) is more than just another policy update from CMS—it’s a fundamental shift in how hospitals and provider networks are held accountable for total cost and quality of care.
As a mandatory Alternative Payment Model (APM), the TEAM mandate introduces new financial risks, operational challenges, and data-driven expectations. While the model aims to drive efficiency and improve outcomes, success depends on how well participants prepare, leverage data, and build strong networks.
For a detailed breakdown of AJMC’s findings, download the full article in PDF format here:
TEAM Mandated Preparation: The Key to Success
With the TEAM mandate’s focus on cost containment and quality performance, organizations must proactively assess their current care delivery models, financial exposure, and operational workflows. This means:
Conducting internal readiness assessments to identify gaps in care coordination and financial risk management.
Educating teams on the TEAM mandate requirements and reimbursement structures.
Aligning operational strategies to meet TEAM’s quality and efficiency targets before penalties take effect.egies to meet TEAM’s quality and efficiency targets before penalties take effect.
Real-Life Example: A hospital system in the Northeast underestimated the operational challenges of a prior bundled payment program. Case managers were overwhelmed with tracking requirements, and discharge coordination was inconsistent. The result? Missed performance benchmarks and financial penalties.
By conducting an internal readiness assessment, restructuring care teams, and improving discharge planning, they turned things around—improving both patient outcomes and financial performance.
Key takeaway: Organizations that proactively assess their readiness and make targeted improvements will be positioned for long-term stability under TEAM.
Data: The Power to Drive Outcomes
Data is the backbone of success under the TEAM mandate. Providers will need real-time analytics, predictive modeling, and performance tracking to:
Identify high-risk patients and intervene early to prevent costly complications.
Track cost drivers and pinpoint inefficiencies in care delivery.
Ensure accurate reporting, risk capture, and benchmark performance against CMS requirements.
Without a robust data strategy, organizations risk financial penalties and missed opportunities for shared savings.
Real-Life Example: A health system in the Midwest initially struggled with rising costs under a previous alternative payment model. They relied on lagging, retrospective data, which meant they were reacting to issues months after they occurred rather than preventing them.
By implementing predictive analytics and real-time tracking, they reduced preventable hospitalizations by 19 percent and cut total episode costs by 12 percent.
Key takeaway: Organizations without a strong, real-time data strategy will struggle to control costs, meet TEAM mandate benchmarks, and maximize financial incentives under TEAM.
Provider Networks: Collaboration is Non-Negotiable
TEAM does not reward siloed care—it demands strong partnerships across the continuum. Providers must:
Establish high-performing networks with hospitals, physicians, and post-acute care providers.
Standardize care pathways and communication protocols to ensure seamless transitions.
Develop financial alignment models that fairly distribute risk and rewards across all stakeholders.
Real-Life Example: A regional hospital in the South struggled with high post-acute care costs and inconsistent discharge outcomes. Their skilled nursing and home health partners lacked standardized protocols, leading to unnecessary rehospitalizations and increased episode costs.
By establishing preferred partnerships with high-performing post-acute providers, they:
Reduced skilled nursing facility stays by 15 percent
Lowered readmissions by 22 percent
Saved over $1.5 million in post-acute care costs in the first year
Key takeaway: The hospitals that actively build high-performing provider networks will have a major advantage under the TEAM mandate.
Why TEAM Connect Matters
Hospitals and provider networks cannot tackle TEAM in isolation. The most successful organizations will learn from each other, share best practices, and collaborate to navigate CMS’s evolving requirements.
That’s why TEAM Connect was created—a strategic forum where healthcare leaders come together to:
Break down TEAM’s complexities in real time
Share best practices for risk mitigation, data utilization, and provider network development
Stay ahead of CMS policy updates and performance benchmarks
Leverage collective experience to drive success
TEAM isn’t just about compliance—it’s an opportunity to lead in value-based care. The hospitals and provider networks that invest in collaboration, data intelligence, and proactive strategies will be the ones defining the future of value-based care.
Join TEAM Connect today and take a smarter approach to this new model.
Final Thoughts
TEAM is not a passing trend—it’s the next evolution of value-based care. The question is not whether hospitals will adapt, but how well they will prepare to succeed.
Organizations that take proactive steps now—investing in data, partnerships, and shared learning—will not just survive but thrive under CMS’s new mandate.
The time to act is now.
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