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People with Traditional Medicare who undergo surgery may experience fragmented care, which can lead to complications and prolonged recoveries. To address this issue, and based on lessons learned from previous episode-based payment models, the CMS Innovation Center has proposed a new mandatory 5-year, episode-based alternative payment model that would launch in 2026.
The mandatory Transforming Episode Accountability Model (TEAM) would aim to improve the patient experience from surgery through recovery by supporting the coordination and transition of care between providers and promoting a successful recovery that can reduce avoidable hospital readmissions and emergency department use. TEAM episodes would begin with lower extremity joint replacement, surgical hip femur fracture treatment, spinal fusion, coronary artery bypass graft, and major bowel procedures.