Definition
What Is The CMS TEAM Model?
The Transforming Episode Accountability Model (TEAM) is a mandatory five-year Medicare bundled-payment program administered by the Centers for Medicare & Medicaid Services. It holds 741 selected acute-care hospitals financially accountable for the cost and quality of five high-volume surgical episodes from admission through 30 days post-discharge. TEAM began January 1, 2026 and runs through December 31, 2030.
TEAM is part of Medicare's continued shift from fee-for-service to value-based care. Hospitals are reimbursed for the entire surgical episode rather than for individual services, with reconciliation payments and penalties adjusted by the Composite Quality Score (CQS).
How TEAM Works: Four Pillars
These four pillars describe how CMS structured the model. For the CFO playbook on capturing upside, see the five revenue levers.
1. The Episode
Begins the day of the qualifying surgery and runs for 30 days post-discharge. The hospital is accountable for all Medicare Part A and Part B spending during that window, including post-acute care, readmissions, and complications.
2. The Five Procedures
Coronary Artery Bypass Graft (CABG), Lower Extremity Joint Replacement (LEJR: hip, knee, ankle), Major Bowel Procedure, Surgical Hip/Femur Fracture Treatment (SHFFT), and Spinal Fusion (cervical, thoracic, lumbar).
3. The Tracks
Track 1 (no downside risk, medium reward), Track 2 (lower risk and reward, years 2–5), Track 3 (highest risk and reward across all five years). Safety-net hospitals can extend Track 1 to three years.
4. The Quality Score
The Composite Quality Score (CQS) adjusts reconciliation based on six measures: Hybrid Hospital-Wide Readmission, THA/TKA PRO-PM, HH-Falls with Injury, HH-Post Respiratory Failure, Failure to Rescue, and PSI-90.
Common Questions
Is CMS TEAM mandatory?
Yes. CMS TEAM is a mandatory five-year payment model. The 741 selected hospitals do not have the option to decline participation. Hospitals must elect a participation track (1, 2, or 3) each performance year.
How long does CMS TEAM last?
TEAM has five performance years, beginning January 1, 2026 and running through December 31, 2030.
Which hospitals are subject to TEAM?
TEAM applies to acute-care hospitals paid under the Inpatient Prospective Payment System (IPPS) located within selected Core Based Statistical Areas (CBSAs). The 741 hospitals on CMS's participant roster include safety-net hospitals, rural hospitals, Medicare Dependent Hospitals, Sole Community Hospitals, Essential Access Community Hospitals (EACH), and many former BPCI Advanced and CJR participants.
Why did CMS create TEAM?
TEAM advances Medicare's shift from fee-for-service reimbursement to value-based care. CMS's goal is to reduce surgical episode costs while improving quality, by making hospitals accountable for outcomes across the entire 30-day post-discharge window — not just the inpatient stay.
What predecessor programs led to TEAM?
TEAM builds on lessons from earlier CMS bundled-payment programs, including BPCI Advanced (voluntary) and the Comprehensive Care for Joint Replacement Model (CJR, mandatory). Many TEAM-mandated hospitals previously participated in one or both.