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.

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.

When this model begins

This five-year mandatory model begins January 1, 2026, and runs through December 31, 2030.

What episodes are included

5 surgical episodes:

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

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

Learn and act with ASA Alternative Payment Model (APM) resources.