Introduction to Medicare's Transforming Episode Accountability Model (TEAM)

On September 5, 2024, the Centers for Medicare & Medicaid (CMS) published a list of acute care hospitals located in one of the Core Based Statistical Areas (CBSAs) selected for mandatory participation in the Transforming Episode Accountability Model (TEAM). TEAM is a mandatory, episode-based, alternative payment model, in which selected acute care hospitals will coordinate care for people with Traditional Medicare undergoing one of the surgical procedures included in the model (initiate an episode) and assume responsibility for the cost and quality of care from surgery through the first 30 days after the Medicare beneficiary leaves the hospital. This five-year mandatory model begins January 1, 2026, and runs through December 31, 2030.

Why this alternative payment model

Model Goals:

Test financial accountability for surgical episodes in reducing expenditures while preserving or enhancing the quality of care for Medicare beneficiaries.
Encourage hospitals to provide coordinate, high-quality care during and after certain surgical procedures.

5 surgical episodes are included:

Coronary artery bypass graft (CABG)
Lower extremity joint replacement (LEJR)
Major bowel procedure
Surgical hip/femur fracture treatment (SHFFT)
Spinal fusion

Episode length:

Begins with inpatient stay or outpatient procedure
Ends 30 days post-discharge
Episode items include all Medicare Part A and B items and services unless specifically excluded

Latest Resources

Watch the ADVANCE session, CMS Bundled Payments: Role of Anesthesiologists in Aligning Quality and Economic Goals, where experts discuss TEAM implementation at https://plus.asahq.org/media/9418cb71-9ffb-4774-9272-10dfce066176. This requires an ASA Plus subscription.
Listen to this podcast (Episode 176) to learn about the model, who will be impacted, and how you can lead at your organization.
Watch the Annual meeting session, Making the TEAM: Using Quality Data to Demonstrate Your Value to Hospital Administration in CMS' New Bundled Payment Model, at https://plus.asahq.org/media/9418cb71-9ffb-4774-9272-10dfce066176.
Process Makes Perfect: The Role of Anesthesiologists in the CMS TEAM (ASA Monitor article)
Calendar Year (CY) 2026 Medicare Conversion Factors Higher for Physicians in Alternative Payment Models | American Society of Anesthesiologists (ASA) (Timely Topic article)

Who needs to participate in the TEAM model

Quickly see if your hospital is selected for mandatory participation using our interactive map .

TEAM Participation Tracks

Track	Performance Year (PY)	TEAM Participant Eligibility	Financial Risk
1	1	All TEAM participants	Upside risk only (10% stop-gain limit) CQS* adjustment percentage of up to 10% for positive reconciliation amounts
1	1-3	TEAM participants that are safety net hospitals	Upside risk only (10% stop-gain limit) CQS adjustment percentage of up to 10% for positive reconciliation amounts
2	2-5	TEAM participants that meet one of the following hospital criteria: Safety net hospital Rural hospital Medicare Dependent Hospital Sole Community Hospital Essential Access Community Hospital	Upside and downside risk (5% stop-gain/stop-loss limits) CQS adjustment percentage of up to 10% for positive reconciliation amounts and CQS adjustment percentage of up to 15% for negative reconciliation amounts
3	1-5	All TEAM participants	Upside and downside risk (20% stop-gain/stop-loss limits) CQS adjustment percentage of up to 10% for positive and negative reconciliation amounts

^*Composite Quality Score (CQS) is your weighted score.

Additional resources