Introduction to the TEAM Model CMS
The Centers for Medicare & Medicaid Services (CMS) has introduced the Transforming Episode Accountability Model TEAM, a mandatory, episode-based payment model designed to enhance the quality and cost-effectiveness of care. Starting January 1, 2026, this five-year initiative aims to hold hospitals accountable for the cost and quality of care for specific surgical procedures, including lower extremity joint replacements, surgical hip femur fracture treatments, spinal fusions, coronary artery bypass grafts, and major bowel procedures. By setting price targets and utilizing financial incentives and penalties, the TEAM model CMS encourages hospitals to manage resources efficiently and improve patient outcomes.
Technology Partners for Success in TEAM Model CMS
To succeed in the TEAM model CMS, hospitals need technology partners that offer robust data infrastructure, advanced analytics, and comprehensive care coordination tools. These partners must provide solutions that help hospitals:
- Capture and Analyze Data: Efficiently gather and interpret clinical and financial data.
- Identify and Manage Episodes: Accurately identify episodes and manage them proactively.
- Optimize Costs: Identify cost-saving opportunities without compromising care quality.
- Enhance Patient Outcomes: Use data-driven insights to improve patient care and reduce readmissions.
- Ensure Continuity of Care: Track patients throughout their care journey to minimize gaps in treatment.
- Benchmark Performance: Compare performance against national and regional standards to identify areas for improvement.
Persivia’s Role in Supporting the TEAM Model CMS
Persivia, with its extensive experience in both population-based and episodic models, is ideally positioned to support healthcare organizations participating in the CMS TEAM model. Persivia success is rooted in a decade and half working of building AI models and Clinical knowledge assets. Our AI-driven integrated platform has proven success in driving outcomes in models like the Bundled Payments for Care Improvement Advanced (BPCI-A). Here’s how Persivia can help hospitals thrive under the TEAM model:
1. Full Program Orchestration
We offer full program orchestration for successful episodic models, establishing a robust data infrastructure to capture, analyze, and interpret clinical and financial data. This foundation is crucial for making informed decisions and driving improvements in care and cost management.
2. Proactive Care Planning
Timely identification of episodes based on population demographics and performance metrics allows for proactive planning. We identify patients eligible for those episodes at the time of admission, enabling early intervention and better care coordination.
3. Advanced Analytics
Our advanced analytics capabilities allow us to identify high-risk patients through multi-layered risk stratification. This enables the creation of personalized care plans aimed at enhancing patient outcomes and reducing costs. We also track performance metrics in real-time, helping you identify opportunities for cost optimization and ensuring that you meet your bundled payment arrangement goals.
4. Continuous Patient Tracking
Effortlessly track patients throughout their anchor and post-anchor stays with real-time care alerts. This promotes continuity of care and helps reduce gaps in treatment.
5. Evidence-Based Care Pathways
We design evidence-based and patient-centered care pathways that encompass the entire episode of care, ensuring that every step of the patient journey is optimized for the best outcomes.
6. Seamless Care Transitions
We ensure seamless care transitions with a strong network of high-quality providers across the care continuum, including hospitals, post-acute care facilities, and home health agencies.
7. Digital Tools and Patient Involvement
Utilize digital tools for remote monitoring, telehealth, and patient communication to support active patient involvement and enhance care delivery.
8. Benchmark Comparison
Compare your performance to national and regional benchmarks to understand where you stand and identify areas for improvement.
9. Responsive Service and Flexible Platform
Experience responsive service and a flexible platform designed to speed up results for all episodic models. Our approach is tailored to meet the specific needs of your organization and adapt to the evolving healthcare landscape.
Conclusion
Persivia’s proven track record in leveraging advanced technology to drive better healthcare outcomes positions us as a valuable partner for organizations navigating the new TEAM model CMS. By partnering with us, hospitals can ensure they have the tools and support necessary to excel in this innovative payment model, ultimately enhancing the quality and cost-effectiveness of patient care. Together, we can achieve the goals of improved healthcare outcomes and cost management, making the TEAM model a success for all participants.
Learn how Prime Healthcare save $17 millions and reduced readmissions by 15%.
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