Navigating the CMS TEAM Model: What Orthopedic Leaders Need to Know Now

The Transforming Episode Accountability Model (TEAM) is set to reshape healthcare bundled payments, presenting both challenges and opportunities for orthopedic practice professionals. Launching on January 1, 2026, TEAM will cover five surgical service lines, with three specifically targeting orthopedic procedures: major joint replacement, surgical hip and femur fracture, and spinal fusion. Unlike previous models, TEAM introduces a more focused 30-day bundle approach, requiring practices to be strategic and precise in their care management. 

Data will be the most critical asset for orthopedic practices navigating this new model. Professionals must proactively request and analyze historical Medicare spending data, identifying key areas for cost reduction and performance improvement. The most significant opportunities lie in optimizing post-acute care, including reducing inpatient rehab admissions, minimizing skilled nursing facility stays, and streamlining home health utilization. 

Collaboration will be paramount in the TEAM model. Orthopedic practices should develop strong partnerships with hospitals, offering expertise in managing orthopedic episodes and creating comprehensive co-management agreements. Building a robust patient-reported outcomes (PROMs) collection infrastructure will be crucial, as these metrics directly impact quality composite scoring and potential reimbursement. 

Successful practices will need to stay ahead of CMS performance measures, understand regional pricing dynamics, and prepare for potential gain-sharing opportunities. This requires a proactive approach to data analysis, care coordination, and strategic planning. While the TEAM model presents complex challenges, it also offers innovative orthopedic practices a chance to demonstrate their value in the evolving healthcare landscape. 

The key to success will be adaptability, data-driven decision-making, and a commitment to delivering high-quality, cost-effective patient care. Practices that invest time in understanding the nuances of the TEAM model and develop comprehensive strategies will be best positioned to thrive in this new bundled payment environment. 

Generative AI was used in part to generate this content.