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The Medicare TEAM Model: A Strategic Guide for Orthopaedic Surgeons
Abhinav R Balu1, David Kalainov1, Adam Edelstein1
1Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
None:
➢ The Medicare Transforming Episode Accountability Model (TEAM) is a 5-year payment model that started on January 1, 2026, with mandatory participation from >700 U.S. hospitals in 5 surgery categories, 3 of which are orthopaedic. ➢ The TEAM encompasses a specified operation from the day of the admission or outpatient procedure to 30 days after discharge, with payment based on a hospital-specific target price that is adjusted for hospital demographic characteristics and a Composite Quality Score multiplier. ➢ Although hospitals hold the financial risk and benefit, orthopaedic surgeons will drive the TEAM's success, making their strategic engagement with leadership essential. ➢ Robust data infrastructure, along with timely collection and analysis, forms the foundation for the TEAM implementation and compliance. ➢ Many hospitals are unprepared for the TEAM, and the inclusion of high-variability procedures, such as the surgical treatment of hip and femoral fractures and spinal fusion, heightens financial risk, underscoring the need for a clear strategic framework and orthopaedic surgeon leadership.
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