Glossary

CMS TEAM Glossary

Every key term in the CMS Transforming Episode Accountability Model — defined plainly, for hospital executives, CFOs, CMIOs, and compliance leaders. 21 terms.

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BPCI Advanced (Bundled Payments for Care Improvement Advanced): A predecessor CMS voluntary bundled-payment program. Hospitals that participated in BPCI Advanced may be among those mandated under TEAM.
CABG (Coronary Artery Bypass Graft): One of the five TEAM episode types. Coronary revascularization by coronary artery bypass graft surgery.
Care Coordination: The deliberate organization of patient care activities across settings and providers during an episode. Under TEAM, the hospital is accountable for total episode cost and quality for 30 days post-discharge, making coordination across surgeons, PCPs, SNFs, and home health essential to financial performance.
CBSA (Core Based Statistical Area): A U.S. Office of Management and Budget geographic designation used by CMS to scope TEAM participation. Only hospitals located within selected CBSAs are subject to the mandate.
CJR (Comprehensive Care for Joint Replacement Model): A predecessor CMS mandatory bundled-payment program focused on hip and knee replacement. CJR provided much of the operational blueprint for TEAM.
CMMI (Center for Medicare and Medicaid Innovation): The CMS innovation center responsible for designing, testing, and evaluating new payment and service delivery models — including TEAM.
CMS TEAM (TEAM, Transforming Episode Accountability Model, CMS TEAM Model): A mandatory Medicare bundled-payment program administered by the Centers for Medicare & Medicaid Services that holds 741 selected acute-care hospitals accountable for the cost and quality of five surgical episodes through 30 days post-discharge. Began January 1, 2026 and runs five performance years.
Composite Quality Score (CQS): A TEAM-specific quality measurement that adjusts financial reconciliation based on a hospital's performance across measures including Hybrid Hospital-Wide Readmission, THA/TKA PRO-PM, HH-Falls with Injury, HH-Post Respiratory Failure, Failure to Rescue, and PSI-90.
FHIR (Fast Healthcare Interoperability Resources, FHIR R4): A modern standard for exchanging healthcare data electronically. TEAM compliance platforms use FHIR R4 APIs to ingest clinical records from the hospital EHR and share episode data across care settings during the 30-day accountability window.
IPPS (Inpatient Prospective Payment System): The Medicare payment system under which TEAM-eligible acute-care hospitals are reimbursed for inpatient services.
LEJR (Lower Extremity Joint Replacement): One of the five TEAM episode types. Includes hip, knee, and ankle replacements; excludes arthroplasty of the small joints in the foot.
Major Bowel Procedure: One of the five TEAM episode types. Major small- or large-bowel surgery.
PSI-90 (Patient Safety and Adverse Events Composite): A composite patient-safety measure used in the CMS Hospital-Acquired Condition (HAC) Reduction Program and incorporated into the TEAM Composite Quality Score.
RAIN COMPLIANT (R.A.I.N. Compliant™, Referral Accountability for Integrated Networks, RAIN Compliant, RAIN COMPLIANT): Rainfall Health's flagship product. An EHR-integrated, AI-enabled compliance platform built for the CMS TEAM Model. Provides real-time episode tracking, automated compliance documentation, cross-provider data sharing, and risk-adjusted cost and quality analytics.
Safety Net Hospital: A hospital designation that confers additional flexibility under TEAM, including up to three years of no-downside-risk participation in Track 1.
SHFFT (Surgical Hip/Femur Fracture Treatment): One of the five TEAM episode types. Hip fixation procedures in the presence of a hip fracture, with or without fracture reduction. Excludes joint replacement.
Spinal Fusion: One of the five TEAM episode types. Includes cervical, thoracic, and lumbar spinal fusion procedures.
TEAM Episode: A discrete unit of care under TEAM that begins on the day of a qualifying surgical procedure and ends 30 days after the patient is discharged. The hospital is financially accountable for all Medicare Part A and Part B spending during this window.
Track 1: TEAM participation track with no downside risk and a medium upside reward, available for one year (three years for safety-net hospitals).
Track 2: TEAM participation track available in performance years 2–5 for specific hospital types, with lower risk and lower reward than Track 3.
Track 3: TEAM participation track with the highest financial risk and highest reward, available for all five performance years.