TEAM Model Poised to Reshape Post-Acute Care with Varying Provider Readiness

The Transforming Episode Accountability Model (TEAM) is set to launch in January, requiring mandated participation from selected hospital systems. The readiness among skilled nursing facilities (SNFs) and hospitals varies significantly, with some SNF operators educating hospitals about the model, positioning themselves as valuable partners. TEAM represents a major mandatory bundled payment initiative designed to cover all costs associated with a 30-day care episode, focusing initially on five diagnosis-related groups (DRGs). These are lower extremity joint replacement, coronary artery bypass graft, major bowel procedure, surgical hip or femur fracture treatment, and spinal fusion. Genesis HealthCare, a leading SNF provider with nearly 200 centers, has been actively engaging hospital partners about TEAM, emphasizing mandatory participation and the value of established care pathways to optimize outcomes and reduce readmissions. The program incentivizes value-based care practices, with hospitals currently participating mainly in a Tier One track that offers potential financial gains without downside risk. However, future phases may introduce financial penalties and expand the model to encompass more diagnoses and comorbid conditions, such as congestive heart failure, for chronic disease management accountability. Market response has been mixed; some SNFs and hospitals analyze data to enhance collaboration and performance metrics aligned with TEAM’s requirements, while others are in early stages of readiness or have not yet started preparation. Data analytics, including real-time metrics on readmissions, length of stay, and referral responsiveness, are recognized as essential for effective TEAM participation. Genesis utilizes proprietary analytics tools to monitor and manage performance, providing actionable insights to improve clinical coordination and financial oversight. Stakeholders anticipate TEAM to rapidly evolve beyond its initial scope, potentially integrating nested episode bundles within Medicare Accountable Care Organization (ACO) models, thereby broadening the reach of episode-based performance management across post-acute care providers. Skilled nursing providers familiar with managing risk and value-based contracts may find TEAM a natural extension of their existing strategies, while others face challenges in adapting amid concurrent industry pressures such as Medicaid funding changes. Survey data from a recent webinar indicate about 65% of provider respondents feel confident about readiness for TEAM’s implementation, though a significant portion remains in preparation or undecided stages. Providers highlight the critical role of data and analytics for enhancing post-acute care tracking and collaboration with hospital systems. Care pathway integration, especially in orthopedic post-operative care where episode volume is highest, offers opportunities for improved patient outcomes and operational efficiencies. Overall, TEAM is positioned as a transformative framework with longitudinal implications for skilled nursing and hospital partnerships, financial risk management, and quality improvement in post-acute care. Active engagement with data-driven performance measures, care coordination strategies, and evolving regulatory requirements will be key for providers targeting success under this emerging CMS payment model.