Redefining Surgical Care: Inside CMS's TEAM Model Launching January 1, 2026

The Transforming Episode Accountability Model (TEAM) is CMS's boldest effort yet to bring surgical care fully under the value-based care umbrella. Launching January 1, 2026, this mandatory, five-year model (running through December 31, 2030) will apply to selected acute-care hospitals across 188 Core-Based Statistical Areas (CBSAs) nationwide. Its mission is to make surgical care more coordinated, data-driven, and accountable for both cost and quality outcomes.

For the first time, hospitals will be measured not only on how procedures are performed but also on how patients recover post-operation. CMS designed TEAM to address long-standing gaps in surgical care, ensuring system-wide cost control, reducing variation in post-acute outcomes, and improving patient recovery. The model specifically targets better coordination, accountability, and data-driven decision-making across hospitals, post-acute providers, and primary care teams.

TEAM aligns naturally with The Garage Airport Model for Innovation, providing a strategic blueprint for value-based care success. Consider surgical episodes as flights moving through an airport: hospitals, post-acute providers, and primary care teams are the terminals, concourses, and gates, while data, technology, and automation tools serve as air traffic control, orchestrating safe, efficient, and coordinated patient journeys. TEAM's structured care pathways, dual attribution capabilities, and robust quality metrics integrate seamlessly with this model, enabling care teams to navigate complex patient flows and achieve measurable outcomes across the care continuum.

Why TEAM Matters

Surgical recovery has long been the weak link in value-based care programs. Transitions are often fragmented, complications are common, and avoidable readmissions cost Medicare billions annually. TEAM addresses these challenges by uniting hospitals, surgeons, post-acute providers, and primary care teams under a shared set of incentives, driving care transformation by:

• Strengthening coordination from surgery through post-acute and primary care follow-up
• Reducing preventable readmissions and unnecessary emergency department utilization
• Embedding continuity through required primary care referrals
• Aligning incentives with ACOs, MSSP, and broader Medicare value-based frameworks

The ultimate goal: patients receive the right care, at the right time, from a connected and accountable team of providers every time improving both outcomes and experience.

Focus on High-Impact Surgical Episodes

At launch, TEAM will target five high-volume, high-cost surgical procedures:

• Coronary Artery Bypass Graft (CABG)
• Major Bowel Procedures
• Lower Extremity Joint Replacement (LEJR)
• Surgical Hip and Femur Fracture Treatment (SHFFT)
• Spinal Fusion

Each episode begins on hospital admission or outpatient procedure date and extends 30 days post-discharge, covering nearly all related Medicare Part A and B services.

Who Participates

• Mandatory Participants: Acute-care hospitals located in selected CBSAs nationwide. Maryland hospitals and CBSAs with no historical episodes in relevant procedures are excluded.
• Voluntary Participants: Hospitals outside these CBSAs that participated in BPCI Advanced or CJR models through their conclusion are eligible to opt in.
• Beneficiaries: Traditional Medicare fee-for-service enrollees undergoing the specified procedures.

Hospitals choose annually among three participation tracks, balancing risk and reward:

Stop-loss and stop-gain limits cap financial exposure across all tracks. Low-volume hospitals may qualify for additional downside protections.

How TEAM Works

Hospitals continue to bill under normal Medicare fee-for-service, while CMS retrospectively reconciles episode costs against risk-adjusted target prices, accounting for patient clinical complexity, hospital characteristics, and social risk factors.

• If actual spending falls below the target price and quality benchmarks are met, hospitals earn shared savings
• If spending exceeds targets, they may owe repayments

This ensures financial success is tied to better care, not just cost reduction.

TEAM + ACO: A Strategic Bridge

TEAM is more than a bundled-payment model, it signals CMS's vision for converging episode-based care and population health management.

• Dual attribution enables patients to count under both TEAM and an ACO
• Interoperability and data sharing connect inpatient surgical accountability with MSSP, ACO REACH, and other Medicare programs

For ACOs and risk-bearing entities, this creates:

• Visibility into costly surgical episodes that have traditionally escaped population-level management
• Closer alignment of inpatient surgical strategy with outpatient clinical and care management programs
• New partnership opportunities with hospitals to share data, coordinate referrals, and share savings

TEAM creates a fully coordinated care environment where hospitals and ACOs operate as a single, connected team, aligning all efforts toward seamless, patient-centered outcome.

TEAM Readiness: Key Steps with The Garage

Hospitals and ACOs cannot wait; preparation should begin well before launch. Success requires aligning people, processes, and technology across the care continuum. Bridge supports readiness by combining data, agentic workflows and automation, and care coordination into one platform.

Episode Planning

• Identify top-volume TEAM episodes (CABG, LEJR, SHFFT, major bowel, spine)
• Review historical cost and outcome data
• Use Bridge to track historical trends and visualize episode-level data for strategic planning

Care Coordination

• Map workflows across hospital, post-acute, and primary care providers
• Identify gaps in referrals, follow-up, and patient education
• Leverage Bridge TCM workflows to monitor patients post-discharge, ensure medication adherence, and trigger timely follow-ups
• Use the BlazeSync Agent to automate and streamline routine outreach, handoffs, and priority patient lists

Data, Reporting, and Risk Strategy

• Ensure ability to track CMS-required quality measures
• Evaluate interoperability across care settings
• Prepare for Composite Quality Score calculation and reporting deadlines
• Model potential financial outcomes and downside exposure for each track
• Bridge provides analytics, dashboards, and scenario modeling for decision support

Partnerships and Team Alignment

• Engage post-acute care networks and primary care partners early
• Align internal teams across surgery, case management, and population health
• Use Bridge collaboration tools to ensure clear communication and coordinated action

Final Take

TEAM is more than a payment model; it is a strategic blueprint for the next evolution of value-based care. By extending accountability beyond the OR into the full surgical episode, CMS is closing the gap between acute care and long-term outcomes.

Hospitals and ACOs that act now by integrating data, leveraging automation, building partnerships, and aligning workflows will be positioned to lead this new era of coordinated, patient-centered recovery. In Garage's Airport Model framework, TEAM readiness ensures patients move through each stage of care smoothly, safely, and efficiently, with technology and intelligence keeping operations on time and outcomes measurable.