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TEAM Mandate: Innovation in Motion or Just Another Burden?

Updated: 4 days ago

The healthcare industry has never stood still, but CMS’s Transforming Episode Accountability Model (TEAM) is forcing providers into yet another shift—one that raises as many questions as it answers.


On paper, TEAM aims to streamline care coordination, improve cost efficiency, and drive better patient outcomes. But in practice? It could be yet another budget-neutral alternative payment model (APM) that picks winners and losers, leaving many hospitals and providers caught in the crossfire.


The big question: Is TEAM a necessary innovation, or just another layer of administrative and financial burden? The answer depends on how well hospitals and provider networks prepare.



1. TEAM Demands Financial Accountability—But How Much Control Do Hospitals Really Have?


In theory, TEAM gives hospitals a greater role in managing cost and quality across an entire 30-day episode of care—but in reality, much of what drives costs lies outside hospital walls.

Here’s what hospitals are up against:


  • Patient adherence is unpredictable. Even the best care plans fall apart if patients don’t follow discharge instructions, attend follow-up appointments, or take medications as prescribed.

  • Post-acute care is inconsistent. Skilled nursing facilities, rehab centers, and home health providers vary widely in quality and cost efficiency. Hospitals are accountable, but they don’t always have direct control.

  • Social determinants of health (SDOH) drive outcomes. A patient’s housing situation, transportation access, or food security could impact recovery more than any clinical intervention. Yet, hospitals bear the financial risk.


A hospital in the Midwest piloted a bundled payment program for joint replacements. Their inpatient protocols were flawless—but high readmission rates among low-income patients erased potential savings. The issue? Patients lacked reliable transportation to follow-up physical therapy. The hospital’s response? They partnered with a local ride service to ensure high-risk patients made it to therapy. Readmissions dropped, and overall episode costs fell by 18%.

💡Key takeaway: Hospitals cannot afford to tackle TEAM in isolation. Without cross-provider coordination and creative approaches to external risk factors, financial penalties will quickly outpace incentives.



2. More Value-Based Care, More Administrative Burden?


CMS designed TEAM to reward quality care—but many providers worry that, like other value-based care models, it will come buried under mountains of reporting requirements, complex benchmarks, and ever-changing rules.


  • New quality metrics mean more tracking. Providers will need to capture, analyze, and report on data across an extended care episode—not just within hospital walls.

  • Benchmarking mechanisms remain unclear. If historical performance is used to set rates, hospitals that already run lean operations may be unfairly penalized.

  • The paperwork problem is real. Many hospitals still struggle with the complexity of MIPS, ACO REACH, and other CMS programs. Will TEAM streamline the process, or just add another layer of bureaucracy?


A hospital network in the Northeast participated in the Bundled Payments for Care Improvement (BPCI) program with positive clinical results—but high administrative burnout. Their biggest pain point? Endless reporting requirements. Case managers spent more time documenting compliance than engaging with patients. The administrative load led to staff frustration and, ironically, weakened care coordination—the very thing the program aimed to improve.

💡Key takeaway: Hospitals need to assess their administrative capacity upfront. If TEAM follows the same pattern as past APMs, paperwork may outweigh potential benefits—unless reporting requirements are simplified.



3. Who Really Wins? The Benchmarking Challenge


Every mandatory APM claims to drive efficiency and better care, but one question remains: Who benefits the most from TEAM?


  • The financial impact varies considerably across metropolitan areas. This opens up substantial variation in the model's impact within markets.

  • Financial transfer from high cost facilities to lower cost facilities. TEAM creates a financial shift from losers to winners moving dollars from high-cost facilities to the lower-cost high quality facilities.


💡Key takeaway: Hospitals need to understand the financial mechanics behind TEAM benchmarks before assuming that participation will automatically yield financial gains.



TEAM Connect: A Smarter Way to Navigate the TEAM Mandate


Here’s the reality—whether TEAM is a breakthrough or a burden depends entirely on how well hospitals prepare. Those that leverage data, form strong partnerships, and share insights will be the ones that navigate the challenges effectively.


That’s where TEAM Connect comes in.


This collaborative space brings together hospitals, provider networks, and industry experts to:


  • Break down TEAM’s complexities in real time

  • Share strategies for risk mitigation and financial success

  • Discuss best practices for patient engagement, data analytics, and cost control

  • Stay ahead of CMS policy updates and evolving benchmarks


The most successful hospitals won’t just comply with TEAM—they’ll use it as an opportunity to innovate and redefine patient-centered care. But no organization should tackle it alone.


TEAM Connect


Join TEAM Connect today and ensure your hospital stays ahead of the curve.









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