Value-Based Care Insights New Episode NOW On-Demand
On this episode Dan explores the newly introduced the CMS Transforming Episode Accountability Model (TEAM). Informed by earlier initiatives from the CMS Innovation Center, TEAM is a mandatory five-year, episode-based pricing model for hospitals in selected geographic areas. Designed to cover high-volume, high-cost surgical procedures, TEAM represents a significant shift in how hospitals and providers approach bundled payments.
Join Dan and special guest Lucy Zielinski, an expert in value-based programs and HCC coding, as they unpack what the TEAM model entails and what participating hospitals must do to prepare for the January 1, 2026 implementation. Gain insights how this model influences financial performance, drives care coordination redesign, and introduces new incentives and penalties. Whether you are a healthcare leader, provider, or payer, don’t miss this overview of one of CMS’s initiatives shaping the future of value-based care.
Key Takeaways:
- TEAM is a mandatory episode-based payment model affecting 741 acute care hospitals across 188 core-based statistical areas.
- The model targets five key surgical procedures: lower extremity joint replacement, surgical hip/femur fracture treatment, spinal fusion, coronary artery bypass (CABG), and major bowel procedures.
- Participating hospitals must strengthen coding (ICD-10 and HCC) and documentation accuracy, optimize the presurgical evaluation and post-acute care coordination processes , and analyze historical data to gauge risk exposure.
About The Show
Value-Based Care Insights is a radio show on Healthcare NOW Radio, that explores how to optimize the performance of programs to meet the demands of an increasing value-based care payment environment. It is hosted by Dan Marino (@DjmarinoHD) and highlights recognized experts in the field and within Lumina Health Partners (@LuminaHP).
Tune in weekdays at 5:00am, 1:00pm and 9:00pm ET.
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