What are the financial risks in TEAM?  Hospitals are preparing for the launch of the Centers for Medicare and Medicaid Services’ (CMS) Transforming Episode Accountability Model (TEAM) in 2026.   To help you understand both the opportunities and financial risks for participants, DataGen put together a comprehensive white paper, CMS Transforming Episodes Accountability Model Financial Risk Guide.   [Access it Now for Key Updates]  Keep reading for highlights of what’s inside.   Exploring the goals and structure of CMS TEAM Model  CMS TEAM Model is designed to enhance care quality and cost-efficiency. It aims to revolutionize how hospitals manage patient care over 30-day episodes for specific surgical procedures by holding them accountable for the quality and cost of care delivered.   As seen on CMS’ Transforming Episode Accountability Model overview fact sheet , this model not only seeks to improve patient outcomes, but encourages hos...

The end of the CJR model: A look back at its evolution  In October 2024, the final episodes of the Comprehensive Care for Joint Replacement (CJR) model were initiated, with all episodes ending by Dec. 31, 2024. This was the final performance year of CJR, which spanned eight years overall.   CJR began Apr. 1, 2016. It was CMS’ first mandatory bundled payment model. Hospitals were held financially accountable for lower extremity joint replacement (LEJR) episodes of care and were incentivized to improve care coordination for patients across the continuum.    Key insights from CJR: Successes, adjustments and challenges  CJR had numerous ups and downs over the years, as its scope was adjusted over several administrations through the rule-making process. Here are the five main highlights.  1. CJR’s mandatory participation: A changing landscape  When the CJR model was introduced, participation was mandatory for hospitals in 67 metropolitan statistical a...

The Transforming Episode Accountability Model (TEAM) is a mandatory, episode-based alternative payment model developed by the Centers for Medicare and Medicaid services (CMS).    It requires selected acute care hospitals to coordinate care for Medicare beneficiaries undergoing specific surgical procedures, assuming responsibility for the cost and quality of care from surgery through the first 30 days post-discharge.   To prepare for participation in the TEAM model, we’ve put together this blog that hospitals can leverage to ensure model success. If you want a fillable, easy-to-download form, you can access that in our CMS TEAM Model Readiness Checklist. [Access the CMS TEAM Model Readiness Checklist] TEAM readiness checklist breakdown  1. Complete preparation steps: Assess participation status and more  Mandatory participation: Determine if your hospital is located within one of the Core-based Statistical Areas (CBSAs) selected for mandatory participation...

Why hospitals and providers should leverage episodes of care data before TEAM begins  As CMS continues to advance value-based care initiatives, including the Transforming Episodes Accountability Model (TEAM) , hospitals and health systems face increasing pressure to adapt to episodic payment models. To help overcome this pressure, opportunity analysis, which includes simulated TEAM episodes of care, provides a low-risk, data-driven way to prepare for these changes in payment policy and care delivery before TEAM’s formal implementation.  In this blog, we’ll explain why integrating simulated episodes of care into your strategic planning can set your organization up for success under the CMS TEAM model. We’ll also cover the basics of episodes of care and how DataGen helps providers nationwide to access bundled payment opportunity analyses to better understand the expected impact of TEAM, reduce risk and drive improvement.  What are simulated TEAM episodes of care? ...

DataGen partnered with the VBCExhibitHall and the Association of American Medical Colleges (AAMC) to host an informational webinar on CMS’ Transforming Episode Accountability Model (TEAM), Unpacking the mandatory CMS TEAM model: Overcome new rules & challenges.   During this one-hour session, attendees received valuable TEAM insights provided by Alyssa Dahl, vice president of advanced analytics at DataGen, and Erin Hahn, lead policy analyst of value-based care and quality at the Association of American Medical Colleges (AAMC). However, some attendees had good questions that we wanted to elaborate on — hence, the creation of this blog post! Speakers answer your webinar Q&As    With great participant questions during the Q&A portion, Dahl and Hahn took time to expand on their answers to provide more clarity.* So, if you’re a hospital with mandatory TEAM participation status, keep reading to unpack the new rules and challenges.    Q1: What happens...

Is your hospital one of the 741 acute care hospitals mandated?  On Sept. 5, the Centers for Medicare and Medicaid Services (CMS) took another significant step in transforming healthcare delivery by releasing the list of mandatory participants for the Transforming Episode Accountability Model (TEAM) .   If you’re a part of the 741 acute care hospitals selected for mandatory TEAM participation, here’s what you need to pay close attention to, as it marks a pivotal shift in how care is managed and Medicare costs are reconciled across the United States.  Two highlights from the CMS announcement  Mandatory participants announced  CMS’ list of acute care hospitals selected for mandatory participation in the TEAM model includes hospitals located within Core-based Statistical Areas (CBSAs) chosen by CMS. If your hospital is among those listed, it's imperative to understand the implications and prepare for upcoming changes.  Call to action for participating hospital...