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Adoption of value-based care (VBC) programs has continued to expand. For example, the share of healthcare payments from risk-bearing VBC programs where providers could lose revenue if they did not meet quality or cost goals reached 28.5% in 2023, up from 12.5% in 2019.
Despite this steady growth, the Centers for Medicare and Medicaid Services (CMS) will implement a significant policy change in 2026. For the first time, select hospitals must participate in one of its programs.
Approximately 750 hospitals in selected core base statistical areas around the U.S. will be required to participate in CMS’s five-year Transforming Episode Accountability Model (TEAM) program. Selected hospitals will be responsible for the costs and outcomes of fee-for-service Medicare beneficiaries for 30 days after they receive one of five high-volume surgical procedures: lower extremity joint replacement, surgical hip femur fracture treatment, spinal fusion, coronary artery bypass graft, and major bowel procedure.