On-Demand Learning Lab - The CMS TEAM Model: Quality, Care Coordination, and Care Transitions-Recording - The CMS Transforming Episode Accountability Model (TEAM)

Video Transcription

Video Summary

The webinar introduces NACU and its resources, then focuses on CMS’s Transforming Episode Accountability Model (TEAM) and what it means for quality, care coordination, and care transitions. TEAM is a mandatory, episode-based alternative payment model for selected acute care hospitals, designed to reduce fragmented surgical care by holding hospitals accountable for coordinated, high-quality care and total Medicare Part A/B spending across a 30-day episode beginning with an “anchor” hospitalization/procedure.<br /><br />The model covers five surgical episode categories (e.g., lower joint replacement, hip/femur fracture treatment, spinal fusion, CABG, major bowel procedures) and includes most Part A/B services during the episode (readmissions, physician services, post-acute care such as SNF/IRF/home health, etc.). Participants operate under tracks with varying levels of upside/downside financial risk, with reconciliation tied to a composite quality score. Quality measures include readmissions, patient-reported outcomes for hip/knee arthroplasty, and patient safety measures, with updates in later years. Key policies discussed include the SNF 3-day rule waiver (with conditions) and strict beneficiary freedom-of-choice protections.<br /><br />The speaker emphasizes building strong data analytics, rapid-cycle performance improvement, and comprehensive care management/care transition infrastructure, and points to NACU’s competency framework, certification, and micro-credentials as preparation tools.

Keywords

NACU

CMS TEAM model

episode-based payment

acute care hospitals

30-day surgical episodes

care coordination and transitions

Medicare Part A/B spending

SNF 3-day rule waiver