Using home hospital to drive innovation within TEAM

Centers for Medicare and Medicaid Services (CMS) has implemented the Transforming Episode Accountability Model (TEAM), a mandatory bundled payment program for major surgical procedures that aims to strengthen postoperative coordination and reduce spending. Home Hospital (HH) programs, launched nationally under the Acute Hospital Care at Home (AHCaH) waiver, have demonstrated lower costs and strong quality signals for patients. While this waiver was initially set to expire in 2025, it was renewed by Congress until 2030, thus allowing HH to continue. HH is an innovative care delivery model that could advance TEAM's goals. We argue that CMS should incorporate HH into TEAM as a pathway for value-based surgical care. Embedding HH within TEAM would enable hospitals to deliver high-quality surgical care beyond traditional inpatient walls.