"All of that just increasingly subsumes the attention of hospital leaders," Fuller said. "We've definitely been surprised — particularly as we've gotten further into the year and we're now four months away from 'go live' — that we haven't seen kind of more readiness across the marketplace."

David Shulkin, former Veterans Affairs Secretary and a member of Sanford Health's board, said that CMS' decision to carry over TEAM from the Biden administration shows that the agency is serious about pushing providers to take on greater clinician and financial responsibility.

"Hospitals that did not get selected in this program should not be ignoring this," Shulkin said. "This is a signal of things to come. These are skills and toolsets that hospitals should be thinking about developing and sharpening up, whether they're in the TEAM model or not, because this is really where healthcare is headed."

However, in the end, Sally Hart, clinical senior director at Optum Advisory, said, "whether or not addressing TEAM is a priority for your organization, documentation of medical necessity for inpatient care and stratifying patient risks with accurate capture of underlying comorbidities should always be a priority. Well trained and informed clinical documentation improvement teams and documenting providers are essential to accurately representing patient complexity for reimbursement and quality measures."

*Advisory Board is a subsidiary of Optum. All Advisory Board research, expert perspectives, and recommendations remain independent.

9 ways to get ready for TEAM right now

By Anne Schmidt and Jennifer Puzziferro

As hospitals and health systems prepare for TEAM, they face a landscape crowded with competing priorities, from workforce stabilization and access challenges to ongoing regulatory shifts. TEAM’s bundled payment structure demands not only cost containment but also measurable improvements in care quality, discharge planning, and post-acute outcomes.

Importantly, for organizations selected to participate, inaction is not a neutral stance — it carries real consequences. TEAM is a mandatory model, and failure to engage can result in financial losses due to unmanaged cost variation, readmissions, and inefficient discharge planning. It may also signal to CMS and other stakeholders a lack of commitment to value-based care, which could impact future participation in innovation models or funding opportunities. In short, doing nothing risks financial exposure, reputational damage, and diminished strategic influence.

To fortify financial success and patient-centered results, organizations must move beyond compliance and embrace strategic transformation. Hospitals and health systems should:

As hospitals and health systems prepare for TEAM, they face a landscape crowded with competing priorities, from workforce stabilization and access challenges to ongoing regulatory shifts. TEAM’s bundled payment structure demands not only cost containment but also measurable improvements in care quality, discharge planning, and post-acute outcomes.

Importantly, for organizations selected to participate, inaction is not a neutral stance — it carries real consequences. TEAM is a mandatory model, and failure to engage can result in financial losses due to unmanaged cost variation, readmissions, and inefficient discharge planning. It may also signal to CMS and other stakeholders a lack of commitment to value-based care, which could impact future participation in innovation models or funding opportunities. In short, doing nothing risks financial exposure, reputational damage, and diminished strategic influence.

To fortify financial success and patient-centered results, organizations must move beyond compliance and embrace strategic transformation. Hospitals and health systems should:

1. Establish a TEAM governance structure with a cross-functional lead and steering committee to oversee implementation, track performance, and resolve barriers across perioperative, inpatient, and post-acute domains.
2. Conduct retrospective episode modeling to identify cost outliers, readmission drivers, and post-acute variation. Apply TEAM’s discount benchmarks to historical data to forecast financial exposure and prioritize interventions.
3. Standardize care maps across the episode, embedding evidence-based protocols for pre-op, inpatient, and post-discharge phases. Include early mobility bundles, discharge readiness assessments, and escalation criteria.
4. Launch prehabilitation and blood optimization protocols to improve surgical readiness and recovery. Integrate mobility coaching, nutrition support, caregiver engagement, and correction of anemia or coagulation issues.
5. Reframe post-acute planning with a “home first with help” approach, training care teams to prioritize outpatient therapy, home health, and remote monitoring. Engage caregivers early and document home readiness in the EMR.
6. Strengthen relationships with post-acute partners, including skilled nursing facilities and inpatient rehab facilities. Establish shared expectations around quality, length of stay, and discharge planning. Where rehab placement is necessary, implement formal agreements that define length of stay targets, therapy intensity, and communication protocols to ensure alignment with episode goals.
7. Determine optimal site of care for surgical services, shifting appropriate procedures from hospital-based settings to ambulatory surgery centers. Use clinical criteria, patient risk stratification, and financial modeling to guide decisions. Ensure alignment with payer policies, patient preferences, and capacity planning. Embed site-of-care determination into pre-op workflows and electronic medical record decision support tools to streamline scheduling and resource allocation.
8. Develop discharge disposition dashboards to track metrics such as percent discharged home, readmission rates by disposition, therapy adherence, and patient-reported outcomes. Segment data by diagnosis-related group and geography to inform targeted interventions.
9. Invest in data infrastructure and interoperability to ensure post-acute partners have access to discharge summaries, therapy plans, and risk flags. Build shared dashboards for episode tracking and use predictive analytics to stratify risk and personalize care pathways.

By taking these steps, organizations can position themselves not only to meet TEAM requirements, but also to lead in value-based care delivery. With strategic foresight, operational discipline, and commitment to patient-centered outcomes, TEAM can catalyze lasting transformation to strengthen care quality, financial resilience, and system-wide alignment.