Series
Healthcare Regulatory Roundup
Twice each month, PYA experts discuss the latest industry developments as part of our popular Healthcare Regulatory Roundup (HCRR) webinar series. In addition to straightforward explanations of those developments and actionable guidance, attendees will be offered the chance to earn continuing professional education units in selected sessions.
Informational Webinar
No CPE credit offered for this session.
The Centers for Medicare & Medicaid Services (CMS) Transforming Episode Accountability Model (TEAM) is a mandatory five-year bundled payment model that makes hospitals financially accountable for the total cost and quality of care across an episode, from the initial procedure through post-discharge recovery. Under TEAM, unwarranted care variation, avoidable complications, and care gaps can create material financial risk.
During this webinar, Angie Caldwell, Lee Ann Odom, and Jason Hardin explained how hospitals can use baseline and Performance Year 1 (PY1) claims data to quantify TEAM exposure, identify where cost variation exists, and prioritize high-impact improvement opportunities. The presenters also demonstrated how an executive-ready dashboard can translate claims data into decision-ready intelligence across care settings, physician performance, and post-acute outcomes. In addition, they outlined a Phase II “insight-to-action” approach that helps organizations move from analytics to sustained operational improvement through governance, targeted interventions, and structured implementation support.
Jason, Angie, and Lee Ann covered the following learning objectives:
- Explained TEAM’s episode-based accountability and the practical implications for managing total episode cost and quality across the continuum of care.
- Reviewed how the transition from Track 1 in Performance Year 1 to Track 3 in Performance Year 2 (2027) increases downside risk and raises the need for proactive episode management.
- Demonstrated how organizations can use baseline episodic claims data from January 2022 through June 2024, together with PY1 data, to assess risk against CMS target prices and identify variation patterns, utilization trends, and cost drivers.
- Discussed common barriers to producing actionable claims insights, including fragmented data, reporting delays, limited analytics capacity, insight complexity, and stakeholder engagement challenges, along with practical ways to overcome them.
- Showed how dashboard insights by care setting and physician performance can be used to prioritize interventions aimed at reducing unnecessary variation and improving outcomes.
- Described an approach to ongoing monitoring using lead indicators and operational measures of success.
- Shared an “insight to action” framework for prioritizing tactical performance improvement efforts.
