Thriving in CMS TEAM and VBC, While Capturing FFS Revenue

11.13.25 | Presented by: Terry Kowalski, Stanford Health Care, ​Dr Sabrina Poon, Robert Lin, and Nicole Harmon, Clarify Health

Maximizing revenue in today’s hybrid world of fee-for-service (FFS) and value-based care is increasingly complex. Consider a single physician referral: that one decision can carry financial implications across thousands of contracts, spanning FFS arrangements, Alternative Payment Models, and initiatives like CMS TEAM. Each choice can mean the difference between protecting margins or leaving thousands of dollars unclaimed.

Members Access Recording

Healthcare providers are facing unprecedented financial pressure—rising costs, shrinking margins, and rapid shifts toward risk-based payment models. In our recent webinar, leaders from Stanford and Clarify Health walked through how organizations can navigate these realities with clarity and control.

💡 Key Topics Covered

1. The Financial Reality Check Hospitals today operate on razor-thin margins, with growing cost pressures and the challenge of sustaining operations in a shifting payer mix.

2. Provider Perspective from Stanford Terry Kowalski shared Stanford’s on-the-ground experience and how payer mix changes are eroding margins as commercial patients transition to Medicare.

3. The Shift Toward Risk With 30% of provider revenue already tied to APMs—and projections approaching 50% by 2030—the complexity of operating in both fee-for-service and value-based models is intensifying.

4. “Contract-Aware Pathway Optimization” Robert Lin introduced an emerging solution for aligning clinical decision-making with contract incentives across varied payment models—removing the guesswork and helping providers operate with financial clarity.

5. Stanford Use Case & Opportunity Insights Exploring TEAM and early opportunity metrics that are applied to operational opportunities for success in TEAM.

6. Deep Dive: CMS TEAM Model Showcased Clarify’s CMS TEAM tool and walked through how hospitals can use contract-aware insights to prepare for the first performance year.