Preparing for Medicare’s New TEAM Model

Why Post-Op Care Is Essential for Success

Beginning in January 2026, Medicare will launch the Transforming Episode Accountability Model (TEAM), a significant advancement in value-based care aimed at improving patient outcomes, care coordination, and cost efficiency. Hospitals, especially acute care facilities, will be directly accountable for the comprehensive care of patients undergoing specific surgical procedures, extending from admission through 30 days post-discharge.

TEAM targets several high-cost, high-volume surgeries, including Lower Extremity Joint Replacement, Surgical Hip Femur Fracture Treatment, Spinal Fusion, Coronary Artery Bypass Graft (CABG), and Major Bowel Procedures. By addressing fragmented care—often the root cause of complications, unnecessary hospitalizations, and increased spending—TEAM emphasizes a seamless, integrated approach.

Understanding the TEAM Model

The TEAM Model will initially run from 2026 to 2030, mandating acute care hospitals in selected geographic regions across the U.S. to participate. Hospitals will have the option of different participation tracks, each presenting varying degrees of risk and potential reward:

• Track 1: Low-risk entry-level participation, ideal for hospitals new to bundled payment systems.
• Track 2: Moderate risk, aimed at safety-net and rural hospitals.
• Track 3: High-risk and high-reward, suited for experienced hospitals comfortable managing bundled payment structures.

Hospitals participating in TEAM must adhere to Medicare’s quality measures, focusing on hospital readmission rates, patient safety metrics, and patient-reported outcomes (PROs). Performance on these metrics will directly affect reimbursement and potential reconciliation payments.

The Crucial Role of Post-Operative Care

Under TEAM, post-operative care isn't just important—it's pivotal. Hospitals will assume responsibility for coordinating all aspects of patient care, extending 30 days beyond hospital discharge. This extended accountability shifts significant focus onto the post-op recovery phase, traditionally a vulnerable period for patients that heavily influences both patient satisfaction and overall costs.

Post-operative care under TEAM involves

• Robust Care Coordination: Ensuring smooth transitions from hospital care to home, outpatient settings, skilled nursing facilities, and home health agencies.
• Proactive Monitoring and Support: Early identification and management of potential complications to prevent hospital readmissions and emergency department visits.
• Enhanced Communication: Clear, consistent communication across healthcare providers, patients, and families, ensuring adherence to recovery plans and facilitating quicker, smoother recoveries.
• Connection to Primary Care: Direct referrals and engagements with primary care providers, reinforcing long-term health and recovery outcomes.

Impact on Hospitals and Patient Outcomes

Effective management of post-operative care under TEAM delivers substantial benefits for hospitals and patients alike. Proactive post-operative monitoring notably decreases hospital readmissions and emergency room visits, directly enhancing hospital performance metrics and reimbursement outcomes. This approach ensures continuous care beyond surgery, covering the complete recovery phase.

Improved care coordination under TEAM accelerates patient recovery, reducing the average duration of post-acute care stays. Faster recoveries boost patient satisfaction and quality of life while optimizing healthcare resource utilization, enabling hospitals to treat more patients without compromising care quality.

Financially, preventing avoidable complications and hospital visits significantly reduces Medicare spending and hospital financial risk. This predictive, proactive care model identifies potential issues early, avoiding costly complications.

Importantly, TEAM adjusts reimbursement for patient social risk factors, motivating hospitals to provide equitable care to underserved populations. This incentive supports hospitals in addressing social determinants of health, fostering comprehensive support systems and improved health equity across diverse patient communities.

Positioning for Success with TEAM

For hospitals, the shift to TEAM demands strategic improvements in post-operative processes. It’s not merely compliance; it’s an opportunity to leverage better patient care to enhance both clinical and financial outcomes. Hospitals prepared to embrace and refine their post-operative care systems will thrive under TEAM, reaping the rewards of improved patient satisfaction, optimized reimbursements, and leadership in value-based care.

As 2026 approaches, proactive hospitals are already assessing their post-op strategies, ensuring that every phase of patient care aligns with TEAM’s ambitious goals and ultimately leads to a sustainable, patient-centered future in healthcare.

Leveraging a comprehensive digital platform for managing the post-operative patient experience positions hospitals to excel under TEAM by effectively tracking patient recovery, enabling timely interventions, and ensuring continuous patient engagement. This advanced approach empowers hospitals to meet TEAM's stringent requirements, significantly enhancing patient outcomes and financial performance through actionable, real-time insights.