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TEAM - Varying Degrees of Perspectives

The healthcare industry has expressed a range of perspectives regarding the Centers for Medicare & Medicaid Services' (CMS) proposed Transforming Episode Accountability Model (TEAM). While the model aims to enhance care coordination and accountability, it has elicited both support and concern from various stakeholders.


Support for TEAM:

  • Care Coordination and Patient Outcomes: CMS suggests that by holding participants accountable for the total costs of care for an episode, TEAM may incentivize improved care coordination, better patient care transitions, and a reduction in avoidable readmissions. (cms.gov)


Concerns Raised:

  • Mandatory Participation and Financial Risk: The American Hospital Association (AHA) has expressed deep concerns about the mandatory nature of TEAM, highlighting significant design flaws. They argue that the model places excessive financial risk on providers with limited opportunities for shared savings, especially considering the substantial upfront investments required. The AHA has urged CMS to either make extensive changes to the model or refrain from implementing it at this time. (aha.org)


  • Impact on Provider Earnings: Research from the Institute for Accountable Care indicates that hospitals could face financial challenges under TEAM. On average, hospitals might lose approximately $500 per episode of care covered by the model, with variations across different regions. For instance, hospitals in Minneapolis-St. Paul could gain an average of $900 per episode, while those in Denver might lose about $1,300 per episode. (modernhealthcare.com)


  • Administrative and Financial Burdens: Commenters have expressed concerns that the mandatory nature of TEAM could increase administrative complexities and financial pressures on hospitals, particularly those already participating in other alternative payment models. There is apprehension that the added responsibilities might detract from patient care and strain resources. (mcdermottplus.com)


Strategic Considerations for Providers:

Given the impending implementation of TEAM in January 2026, healthcare providers are advised to proactively prepare by:


  • Assessing Financial and Operational Readiness: Evaluating current practices to identify areas needing improvement to meet TEAM requirements.

  • Enhancing Data Analytics Capabilities: Investing in robust data systems to monitor performance metrics and inform decision-making.

  • Strengthening Provider Networks: Building collaborative relationships across the care continuum to ensure seamless patient transitions and coordinated care.


By addressing these areas, providers can better position themselves to navigate the challenges and opportunities presented by the TEAM model.




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