The Transforming Episode Accountability Model (TEAM) is a mandatory CMS model in which selected acute care hospitals coordinate care from surgery through 30 days after the patient leaves the hospital, for people with Original Medicare who have one of five surgical procedures. This page is for hospital compliance, quality and care management leaders who are building the program that makes that coordination happen. Integral Healthcare Solutions (IHS) drafts the episode care coordination, discharge transition and post-acute network policies and the quality monitoring procedure for your clinical leaders to review and approve, and your hospital adopts and runs the program.
Last reviewed: October 2026.
What is TEAM, the Transforming Episode Accountability Model?
TEAM is a CMS payment model. The CMS TEAM model page (page opened October 6, 2026) says that "selected acute care hospitals coordinate care from surgery through 30 days post-hospitalization for people with Original Medicare undergoing one of five surgical procedures: lower extremity joint replacement, surgical hip femur fracture treatment, spinal fusion, coronary artery bypass graft, and major bowel procedures."
The same page says "TEAM is a mandatory model and will run for five performance years from January 1, 2026, to December 31, 2030, in selected Core-Based Statistical Areas nationwide." The regulation behind it is subpart E of 42 CFR part 512. 42 CFR 512.500 (Cornell LII copy, page opened October 6, 2026) says the subpart "implements the test of the Transforming Episode Accountability Model (TEAM) under section 1115A(b) of the Act." In IHS's words, the subpart also covers quality measures and reporting, reconciliation and review, data sharing, financial arrangements and beneficiary incentives, beneficiary protections, audits and record retention, and monitoring and compliance.
How long is an episode?
CMS says "Each episode will end 30 days after the individual leaves the hospital."
How do the target price and reconciliation work?
In CMS's description, participating hospitals "will receive a target price to cover all costs associated with the episode of care." Participants "will continue to bill Medicare FFS as usual but will receive target prices for included episodes prior to each performance year." CMS compares actual Medicare fee for service spending with the target price and also assesses quality. A participant may earn a payment or owe CMS a repayment, "subject to a quality performance adjustment."
What are the three tracks?
The CMS page describes a one year glide path and three tracks. Track 1 has no downside risk and a lower reward, for the first year, or for up to three years for safety net hospitals. Track 2 has lower risk and reward for certain participants, such as safety net or rural hospitals, in years 2 through 5. Track 3 has higher risk and reward in years 1 through 5.
In IHS's restatement of 42 CFR 512.520 (page opened October 6, 2026), a participant picks Track 1 or Track 3 for performance year 1 and must notify CMS of its choice "in a form and manner and by a date specified by CMS." CMS assigns Track 1 if none is chosen. For years 2 through 5, CMS assigns Track 3 unless the participant requests and is approved for Track 1 or Track 2. Track 1 requests are approved only for safety net hospitals and cannot be requested for years 4 and 5. Your counsel and finance team confirm what this means for your hospital.
Can a hospital leave the model?
In IHS's restatement of 42 CFR 512.508 (page opened October 6, 2026), participants take part for the full performance period unless CMS terminates TEAM or the participant receives notice of termination, and a hospital that no longer meets the participant definition ends participation then.
Who needs a TEAM care redesign program, and what triggers it?
Hospitals paid under the Inpatient Prospective Payment System that sit in a selected Core-Based Statistical Area are the audience, and the CMS page says such hospitals "are required to participate in TEAM." CMS says the list of selected areas was published in the 2025 IPPS final rule. IHS does not tell you whether your hospital is on it. Your compliance and finance leaders check the participant list on the CMS TEAM page, and your counsel confirms the result.
Points that prompt the program work, in IHS's reading as of October 2026:
- Your hospital appears on the CMS participant list and is moving from awareness to operating procedures.
- The CMS page says CMS published the FY 2027 IPPS and LTCH PPS final rule on July 31, 2026, "which includes updates to TEAM policies." IHS has not read what the updates are, and your counsel and finance team read the rule.
How IHS helps with a TEAM care redesign program
IHS offers process expertise. IHS drafts the program, policies and clinical content for your clinical leaders to review and approve, and your hospital adopts and runs it. The CMS page lists improving care transitions among the model's aims, and says participants "must refer patients to primary care services to enable continuity of care and positive long-term health outcomes."
- Read the CMS page and subpart E with your counsel's scoping decisions in hand.
- Assess the gaps between that text and your current discharge, case management, post-acute and quality documents.
- Map each stated aim to the policy, role, record or report that will support it.
- Draft the episode care coordination policy, the discharge transition procedure, the post-acute network policy, the primary care referral procedure and the quality monitoring procedure.
- Run a mock review of the draft set against the CMS text and your own workflow.
- Support readiness while your clinical leaders, counsel and executives revise and adopt the documents.
What you supply: your CMS participant information, your track decision, your post-acute partner list and your own data.
The limit: IHS does not do episode analytics, target price modeling, financial reconciliation or information technology build. IHS does not decide risk sharing or contracting terms, which belong to your counsel and finance team. IHS does not contact CMS or any contractor, and your hospital submits to CMS whatever it chooses to submit, including any track notice. For related work, see ACHC acute care hospital accreditation, case management and utilization management and utilization management and case management program build.
What to have ready
This is IHS's planning list, built from the CMS page, the regulation text named above and 42 CFR 512.582 (page opened October 6, 2026). It is not a CMS list.
- Your hospital's entry on the CMS participant list, and your counsel's written reading of what it means for you.
- The track your hospital holds for performance year 1 (2026), and the date for any Track 1 or Track 2 request for performance year 2, under 42 CFR 512.520.
- A list of the five procedure types and the surgeons, units and discharge pathways that serve them.
- Your current discharge planning, case management and transition of care policies.
- Your post-acute partner list, covering home health, skilled nursing and rehabilitation relationships, with any written agreements.
- How your hospital now refers patients to primary care after discharge, and who owns that step.
- Your current quality monitoring reports for the five procedures and the committee that reviews them.
- Your counsel's reading of the FY 2027 final rule updates to TEAM policies.
Printable version of this checklist (PDF)
Bring what you have to the free introductory call.
How it compares
A hospital can build the program in house, work with an analytics vendor, or work with a consultant for policies and program design. In IHS's reading, the table sets out how they differ.
| Option | What it covers | Who does it |
|---|---|---|
| Build in house | Policies, procedures, roles and monitoring written by your own staff | Your clinical, quality and compliance leaders |
| Analytics vendor | Episode data, spending against target price, reconciliation analysis | A vendor you select, outside the IHS offer |
| Consultant for policies and program design | Drafting the care coordination, transition, post-acute and quality monitoring documents for your review | IHS drafts, and your hospital adopts and runs |
| Counsel and finance | How the rule applies, risk sharing, contracting terms, financial reconciliation | Your counsel and finance team |
CMS runs other models, such as ACCESS and GUIDE. Each is a separate program, and this page covers TEAM only.
What it costs
The CMS TEAM page describes target prices and reconciliation payments or repayments. IHS read no application fee on that page or in the regulation sections it opened. Verify current requirements with CMS. IHS scopes each engagement after a free introductory call.
What this is not
- IHS is a consulting firm, not a law firm, and this page is not legal advice. IHS gives no opinion on whether TEAM applies to your hospital. Your counsel decides that.
- It is not episode analytics, target price modeling, financial reconciliation or information technology build.
- IHS does not contact CMS or speak for your hospital to CMS or any agency, and it does not predict payment results.
Frequently asked questions
What is TEAM and which hospitals must take part?
TEAM is a mandatory CMS model that runs from January 1, 2026 to December 31, 2030 in selected Core-Based Statistical Areas. CMS says hospitals paid under the Inpatient Prospective Payment System and located in those areas are required to participate. Your counsel confirms whether that includes your hospital.
Which procedures and what episode length?
The five procedures are lower extremity joint replacement, surgical hip femur fracture treatment, spinal fusion, coronary artery bypass graft and major bowel procedures. Each episode ends 30 days after the individual leaves the hospital.
How does the target price and reconciliation work?
CMS gives participants target prices before each performance year, and participants keep billing Medicare fee for service as usual. CMS compares actual spending to the target price and assesses quality, and a participant may earn a payment or owe a repayment.
How do I know if my hospital is in a selected area?
Check the participant list on the CMS TEAM page. CMS also says the list of selected areas was published in the 2025 IPPS final rule. Your compliance leaders do the check, and your counsel confirms what it means.
What changed in the FY 2027 rule?
IHS has not read the changes. The CMS page says CMS published the FY 2027 IPPS and LTCH PPS final rule on July 31, 2026 and that it includes updates to TEAM policies. Your counsel and finance team read the rule.
What does the care redesign program have to cover?
The CMS page IHS read lists no required documents, but 42 CFR 512.582 (page opened October 6, 2026) requires written notice to each TEAM beneficiary before discharge and, in discharge planning, a list of Medicare participating post-acute providers for patients who need that care. Your counsel confirms how it applies. IHS's planning list adds care transitions, post-acute coordination, primary care referral and quality monitoring, which IHS drafts for your clinical leaders to review and approve.
What are the tracks?
Track 1 has no downside risk and a lower reward, Track 2 has lower risk and reward for certain participants, and Track 3 has higher risk and reward. For performance years 2 through 5, CMS assigns Track 3 unless the participant requests Track 1 or Track 2 and is approved. Your hospital decides with its counsel and finance team.
How does TEAM relate to ACOs?
CMS says people in an ACO can still be in a TEAM episode. How your ACO arrangements and your TEAM episodes fit together is a question for your counsel and finance team.
What does IHS do and not do?
IHS drafts the care coordination, transition and post-acute network policies and the quality monitoring procedure for your clinical leaders to review and approve. It does not do episode analytics, target price modeling, financial reconciliation or information technology build, and does not decide risk sharing or contracting terms.
Does a hospital have to build this in house?
Nothing on the pages IHS read requires it. A hospital can write the program itself, use an analytics vendor for the data work, or use a consultant for policies and program design, or a combination.