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Medicare's 2026 to 2030 Transforming Episode Accountability Model (TEAM): Implications for Anesthesiologists
Anjali K Ghoshal1, Robert S Kaplan2, Angela M Bader3
1Harvard Medical School, Boston, Massachusetts; Harvard Business School, Boston, Massachusetts.
Abstract:
Medicare's Transforming Episode Accountability Model (TEAM) represents a significant shift in surgical care reimbursement. TEAM's bundled payment introduces episode-level accountability for cost and outcomes, replacing fee-for-service for discrete activities. TEAM's risk-sharing payments will reshape the clinical and financial environment in which anesthesiologists practice, as their reimbursement is included within the bundle. Their role in perioperative decision-making can strongly influence the performance of hospitals operating under TEAM's risk-sharing arrangements. This article outlines TEAM's structure and examines how episode-based payment models elevate aspects of anesthesiology practice that have traditionally been undervalued under fee-for-service reimbursement. The article also describes the expanded roles for anesthesiologists to prevent complications and to optimize perioperative care. Finally, the article discusses the growing need for anesthesiologists to define, measure, and report outcomes that reflect their contribution to patient recovery and resource utilization. As payment models evolve, aligning anesthesiology practice with episode-level metrics will demonstrate its value for delivering accountable surgical care.