TEAM Payment Model Strategy & Services

The Transforming Episode Accountability Model, or TEAM, is a mandatory CMS episodic payment model effective January 1, 2026, under which selected acute care hospitals assume financial accountability for the total cost and quality performance of defined Medicare episodes. Participation requires hospitals to understand episode targets, reporting requirements, and performance benchmarks tied to reimbursement.

Hospitals preparing for TEAM must assess historical episode performance, identify cost drivers across the care continuum, align internal stakeholders, and structure compliant collaboration arrangements. Early strategy, claims data analysis, and performance planning help organizations manage financial risk and prepare for mandatory value-based payment accountability.

TEAM Model Strategy and Implementation Support Services

Claims Data Analytics

  • Comprehensive and timely dashboards tracking individual episodes and trends
  • Financial modeling to evaluate the impact of performance improvement initiatives
  • Comparative analysis of physician and post-acute provider performance
  • Episode cost analysis by care setting to pinpoint high-cost areas
  • Attending and operating physician performance tracking to align care with standardized protocols
  • Post-anchor episode deep dive to identify care transitions and costly complications
PYA Data, Cybersecurity, & Healthcare Technology Experts

PYA's TEAM Dashboard

  • Converts raw claims data into actionable insights for TEAM performance
  • Provides a 360-degree view of each episode of care
  • Identifies cost drivers across care settings
  • Benchmarks physician performance on episode cost and outcomes
  • Visualizes the patient journey from anchor event through post-acute care
  • Highlights post-discharge utilization and readmission trends
  • Supports informed decisions under the CMS TEAM model

Explore the TEAM Dashboard and Watch the Demo

Performance Improvement

Performance Transformation

  • Develop and implement pre-procedure interventions
  • Quantify internal cost-saving opportunities
  • Evaluate and enhance discharge planning and transitions of care
  • Implement care management and remote monitoring programs
  • Establish processes for post-discharge primary care referrals
  • Assess post-acute care provider costs and outcomes

Collaboration Arrangements

  • Drafting of required policies for partner selection
  • Development and monitoring of gainsharing arrangements
  • Support for negotiations of collaboration agreements
  • Fair market value and commercial reasonableness opinions

Internal Education and Team Building

  • Practical education sessions for board members, management, and key staff
  • Medical staff education and engagement
  • Ongoing regulatory updates

Preparing Hospitals for the CMS TEAM Payment Model

TEAM Payment Model Strategy Services for Hospitals

Understanding the Operational Impact of TEAM

The Transforming Episode Accountability Model (TEAM) is a mandatory episodic payment model beginning January 1, 2026 that will hold selected acute care hospitals accountable for the cost and quality performance of defined Medicare episodes. Hospitals must understand episode performance targets, reporting expectations, and operational requirements tied to the model.

Building Internal Readiness and Performance Transformation Plans

Hospitals preparing for TEAM must evaluate historical episode performance, identify cost drivers across the continuum of care, and align clinical, operational, and financial leaders. Internal education, care redesign, and structured performance transformation planning help organizations prepare for financial accountability under the model.

Data Analytics and Collaboration Arrangements

Successful TEAM participation requires hospitals to monitor episode performance and structure compliant collaboration arrangements with physicians and post-acute partners. Claims data analytics and performance dashboards help identify improvement opportunities and support strategic decision making under the model.

Contact Our TEAM Payment Strategy Team

Team Leaders

Angie Caldwell Headshot Angie Caldwell

Principal and Firm Chief Financial Officer

Lori Foley Headshot Lori Foley

Managing Principal of Consulting

Subject Matter Experts

Carol Carden Headshot Carol Carden

Managing Principal of Compensation Valuation Planning & Design

Jason Hardin Headshot Jason Hardin

Principal and Director of Business Intelligence & Analytics

Michael Ramey Headshot Michael Ramey

Managing Principal of Strategic & Transaction Solutions

PYA
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