TEAM is mandatory. Success isn’t. What hospitals must do now to prepare. 

On Jan. 1, 2026, CMS will launch the Transforming Episode Accountability Model (TEAM), a mandatory 5-year program designed to hold hospitals accountable for both the cost and quality of care delivered around major surgical episodes. TEAM covers 5 high-volume, high-cost procedures, creates two-sided risk, and ties financial performance to outcomes like readmissions, safety, and patient-reported results. 

For hospitals and health systems, TEAM is more than another compliance hurdle. It’s a natural continuation of CMS’ decade-long journey into episode-based care and bundled payments. From the original Bundled Payments for Care Improvement (BPCI) program, to shadow bundles tested across specialties, to the episode-based cost measures introduced in MIPS, TEAM brings these efforts together into a mandatory, scaled model. 

At Healthmonix, we’ve helped providers succeed through every phase of that journey. Here’s what you need to know about TEAM, why it matters, and how the right partner can help you not just comply, but thrive. 

What is TEAM? 

TEAM is structured around episodes of surgical care. Participating hospitals will be responsible for costs and outcomes from the start of a qualifying inpatient or outpatient procedure through 30 days post-discharge. 

Covered surgical procedures 

The model applies to 5 common surgical episodes: 

• Lower extremity joint replacement 
• Surgical hip and femur fracture treatment 
• Spinal fusion 
• Coronary artery bypass graft (CABG) 
• Major bowel procedures 

Episode accountability 

Hospitals will be responsible for nearly all costs associated with these episodes, including: 

• Inpatient and outpatient hospital services 
• Physician services 
• Post-acute care 
• Clinical laboratory services 
• Durable medical equipment 
• Part B drugs 
• Hospice (if within the episode) 
• Readmissions within 30 days 

Importantly, TEAM requires hospitals to connect patients with a primary care provider after surgery. This ensures smoother transitions and supports long-term recovery and health outcomes. 

Quality integration 

Performance isn’t judged on cost alone. Hospitals must meet benchmarks in: 

• Readmissions 
• Patient safety indicators 
• Patient-reported outcomes 

Together, cost and quality determine whether a hospital shares in savings — or absorbs losses. 

TEAM as the next step in bundled payment evolution 

TEAM is not an isolated experiment. It’s the culmination of several CMS efforts to transition from fee-for-service to accountable, episode-based care: 

TEAM is a continuation of this arc. It makes episode-based accountability mandatory, raises the stakes with two-sided risk, and integrates quality in a more direct way. 

Why TEAM will be a challenge 

TEAM is designed to drive accountability at scale, which means it also introduces significant challenges: 

• Mandatory participation: Unlike BPCI or shadow bundles, hospitals can’t opt out. 
• Two-sided risk: After a 1-year glide path, hospitals face both upside and downside financial risk. 
• ACO overlap: Many hospitals already participate in Medicare ACOs, creating overlapping accountabilities that must be carefully managed. 
• Integrated metrics: Cost and quality performance are inseparable, requiring a coordinated approach to care improvement. 

For hospitals, this isn’t just about compliance. It’s about survival in a system that increasingly rewards value over volume. 

How MIPS cost measures provide a head start 

Although TEAM raises the stakes, most hospitals already have experience with episode accountability. The MIPS Cost category has included measures for: 

• Lower extremity joint replacement 
• CABG 
• Hip and femur fracture treatment 
• Spinal fusion 
• Major bowel procedures 

These are the same episodes that anchor TEAM. While the scoring, financial risk, and model requirements differ, the analytic foundation is familiar. Hospitals that have been tracking their MIPS Cost performance — especially those working with partners like Healthmonix — already know where they stand relative to CMS benchmarks. 

This continuity matters. It means TEAM isn’t a cold start; it’s the next level in a progression hospitals have already been navigating. 

Why Healthmonix is the best partner for TEAM

1. Proven CMS expertise

Healthmonix has guided thousands of providers through MIPS, MVPs, ACO programs, bundled payment pilots, and Advanced APMs. We know CMS programs inside and out, and we track every rule-making cycle to anticipate changes.

2. Advanced episode analytics

Our MIPS Cost Analytics (MCA) platform has been breaking down episode-level performance for years. For hospitals preparing for TEAM, this means: 

• You already have insight into your performance on TEAM-relevant episodes. 
• You can identify which providers, service lines, or sites of care are driving cost variation.
• You can model performance under different scenarios before mandatory risk begins. 

3. Integrated quality and cost dashboards

TEAM ties quality metrics directly to financial outcomes. Through Healthmonix, providers see cost data, readmission rates, patient safety indicators, and patient-reported outcomes in a single, unified view.

4. A centralized platform

Healthmonix unifies reporting across MIPS, MVPs, ACOs, Advanced APMs, and now TEAM. Hospitals no longer need to juggle multiple disconnected systems. Healthmonix provides a single source of truth for performance, compliance, and strategic planning.

5. A true partnership

We don’t just deliver software. We deliver strategy.  

Healthmonix works alongside your team to: 

• Model financial exposure under TEAM 
• Develop cost and quality improvement strategies 
• Navigate overlap with ACO participation 
• Align TEAM with your broader value-based care goals 

TEAM goals → Healthmonix solutions 

• Faster recovery after surgery → Analytics to identify care variation and accelerate safe recovery pathways. 
• Fewer avoidable hospital and ED visits → Tools to spot readmission risks and align with patient safety priorities. 
• Smoother transitions to primary care → Reporting across settings to ensure continuity and follow-up. 
• Lower overall costs → Episode-level insights to highlight cost drivers and improvement opportunities. 

Wrapping up 

TEAM represents the next stage in America’s value-based care journey. It’s the logical continuation of bundled payments, shadow bundles, and MIPS cost measures — now scaled up and mandatory. 

For hospitals, the message is clear: success requires mastering episodes, quality, and risk simultaneously. 

With Healthmonix as your partner, you’ll be ready.  

• We bring unmatched CMS expertise. 
• We deliver actionable episode-level analytics. 
• We unify cost and quality in one platform. 
• We partner with you to reduce risk, improve outcomes, and maximize financial performance. 

TEAM is coming. With Healthmonix, you won’t just comply — you’ll win. 

👉 Contact us today to learn how we can help your organization prepare for TEAM.