Is Your Hospital Prepared for the Financial Risk of the CMS TEAM Model?
Every surgical episode delayed costs hospital margin. Discover your projected financial exposure, post-acute leakage, and clinical compliance score in under 60 seconds.
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Evaluate Your Mandatory TEAM Exposure
Select the option matching your hospital’s current state. Your live composite readiness score updates instantly with every answer.
How does your hospital track post-acute care spend, SNF length of stay, and readmission risk after discharge?
What is your current pre- and post-op PROM completion rate across eligible surgical episodes?
Are your clinical care protocols standardized across all orthopedic, cardiac, and general surgical lines?
How do you identify high-risk surgical patients prior to admission to prevent 30-day readmissions?
Do you have formalized preferred provider networks (SNF / Home Health) with quality and cost covenants?
Has your hospital developed the mandatory Health Equity Plan & SDOH screening required by CMS?
Do you have an active gainsharing or incentive model in place with operating orthopedic & cardiac surgeons?
Can your finance team simulate CMS 3-year historical baseline target prices and downside penalty scenarios?
Critical margin leakage vulnerabilities identified in post-acute coordination and PROM collection.
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How Hospital Leaders Protect Bundled Margins With SolvEdge
"The SolvEdge readiness audit immediately pinpointed that 42% of our joint replacement episodes were suffering from post-acute care leakage and excess SNF days. Their prioritized action plan gave our finance and clinical teams the exact roadmap to negotiate high-performing network covenants ahead of the CMS TEAM mandate."
"Meeting the mandatory 50% PROM threshold seemed daunting across our surgical staff. SolvEdge’s assessment provided the automated digital outreach pathways we needed to achieve 78% completion without placing additional administrative load on our nursing staff."
Frequently Asked Questions About the CMS TEAM Model
Essential regulatory facts every healthcare executive must know before January 2026.
What is the CMS TEAM Model and why is it mandatory?
The Transforming Episode Accountability Model (TEAM) is a mandatory 5-year alternative payment model created by the Center for Medicare and Medicaid Innovation (CMMI). Beginning January 1, 2026, selected acute care hospitals are held financially accountable for the total cost of care and quality across a 30-day episode window for 5 inpatient and outpatient surgical categories.
Which surgical episodes are included in TEAM?
The model covers five core clinical episodes: Lower Extremity Joint Replacement (LEJR), Surgical Hip and Femur Fracture Treatment (SHFFT), Spinal Fusion, Coronary Artery Bypass Graft (CABG), and Major Bowel Procedures.
What happens if a hospital fails to meet the 50% PROM threshold?
Under CMS TEAM quality guidelines, hospitals that fail to achieve at least 50% completion rates for Patient-Reported Outcome Measures (PROMs) on eligible elective joint replacement patients will incur a mandatory financial quality penalty, reducing reconciliations and increasing downside repayment obligations.
How does SolvEdge assist hospitals in mitigating TEAM downside risk?
SolvEdge integrates AI-powered episodic analytics, automated digital PROM collection (reaching 78%+ compliance), post-acute care narrow network scorecards, and OIG-compliant physician gainsharing models to ensure hospitals consistently beat CMS target prices and protect surgical margins.