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Rainfall Health stands ready to assist health systems impacted by TEAM, helping them achieve up to 20% increases in revenue
San Francisco, November 17, 2025 – On November 15, 2025, the Centers for Medicare and Medicaid Services (CMS) started sending 742 hospitals and health systems impacted by the Transforming Episode Accountability Model (TEAM) letters indicating their pricing targets and quality scores for 2026. This new model positions hospitals to earn up to 20% in increased revenue from existing lines of service, yielding more than $100 million in total cost savings per facility. To help them navigate these requirements starting on January 1, 2026, Rainfall Health serves as the only product on the market that can act as a single blueprint for navigating compliance in this new era of reimbursement.
Every year, Medicare pays $19.2 billion for the five highest-spend surgical procedures: lower extremity joint replacement, spinal fusion, coronary artery bypass graft, major bowel procedures, and hip/femur fracture treatment. However, the quality of the outcomes associated with those procedures vary dramatically. To help solve this problem and reduce costs for millions of Americans undergoing these medical procedures each year, CMS issued a final rule this July that codifies TEAM. This value-based payment model will help align payment with outcomes, efficiency, and coordinated care.
Starting on January 1, 2026, hospitals will have the sole responsibility to coordinate and pay for entire episodes of care, increasing accountability in order to drive measurable improvements in quality and surgical outcomes. The composite quality score that hospitals receive this month, a brand new CMS metric, is based on the facility’s geographical region, historic spending, adjustments for case mix, and performance on certain measures. At the end of each performance year, CMS assesses hospital targets and either penalizes or financially rewards those participating.
“What most hospitals and health systems aren’t realizing is the potential that TEAM brings to generate billions of dollars in incentive payments,” said Eddie Qureshi, CEO and Founder of Rainfall Health. “There is a real financial upside and revenue opportunity for those that select Track 3 in 2026, and the 80% of facilities that will be in Track 3 starting in 2027. Rainfall provides hospitals with a one stop shop to take advantage of the financial incentives with its AI-powered solution. We streamline new mandated processes and provide a comprehensive, scalable, and automated approach that ensures compliance in this new reimbursement era.”
To meet TEAM requirements and the near real-time data infrastructure demands, health systems will need to collect, standardize, and report on patient outcomes in ways that cannot be done manually. Those that leverage technology and AI tools will be the ones that reap the benefits of the incentive payments included in TEAM.
“TEAM has the ability to align incentives in a way that the US healthcare system has never done before,” said Dr. David Shulkin, former VA Secretary and Sanford Health Board Member. “Whereas prior efforts, like the electronic health record roll-outs made silos even worse, this model is giving us a new chance to leverage technology and AI successfully. I look forward to seeing its impact on moving the value-based care needle and encouraging hospitals to align financial incentives with quality patient outcomes.”
Rainfall Health is proud to assist facilities nationwide in adopting AI solutions to better manage the new CMS mandate. We are the only certification mark that is working to get not only health systems, but also post acute care vendors compliant for maximum reimbursement (known as “RAIN Compliant”). If you are a provider in the United States and you perform these procedures, visit this website to see if you are directly mandated to participate in TEAM on January 1, 2026.
