On average hospitals in TEAM have over 300 Medicare Fee-for-Service patients each year across the five surgical episode types and the average episode cost is over $40,000 so hospitals on average will have over $10M of episode spend in the program. TEAM bases its target prices on regional pricing instead of historical hospital-specific spending, which means hospitals will be competitive within their geographic area. With quality measures such as readmission rates and patient safety indicators impacting payments, hospitals must improve clinical outcomes in addition to cost efficiency to succeed.
Strategies for Success in TEAM
Hospitals preparing for TEAM should prioritize key strategies for success:
- Leverage Data Analytics: Hospitals will benefit from using detailed data to benchmark costs, identify inefficiencies, and prioritize high-impact changes. Access to national Medicare claims data is essential for understanding regional pricing trends and targeting performance improvements.
- Engage Providers: Physician and care team engagement is critical. Gainsharing arrangements and transparent communication ensure alignment between clinical and financial goals.
- Optimize Care Coordination: Hospitals should streamline care pathways, from preoperative preparation to post-acute transitions, reducing unnecessary variation and improving outcomes.
- Focus on Standardization: Implement evidence-based clinical protocols to improve consistency and reduce avoidable complications.
- Track Costs and Outcomes: Ongoing monitoring of financial performance and quality metrics enables making timely adjustments to care.
The TEAM Program Collaborative
To support hospitals in meeting these demands, Avant-garde Health is organizing a Collaborative to help hospitals prepare to thrive in TEAM. Key elements of the Collaborative include:
- Strategic Guidance: Avant-garde will provide coaching to each hospital to develop actionable plans to align their operations with TEAM’s financial and quality requirements.
- Education: The Collaborative will include webinars that cover a range of topics from TEAM program requirements to physician engagement and lessons from prior bundled payment programs.
- Peer Networking: Hospitals can share best practices and learn from others facing similar challenges.
- Track Selection Analytics: Avant-garde will analyze the baseline data CMS provides each hospital to help inform the best TEAM track.
Avant-garde Health brings extensive experience to the program, having supported hospitals in bundled payment models since the inception of both the CMS CJR and BPCI Advanced programs. Avant-garde also has national Medicare FFS data for the last decade and a proven track record of thought leadership in value-based care. Avant-garde has co-authored twelve Harvard Business Review articles, including How One Hospital Has Succeed in a World of Bundled Payments and Physicians Can Help Cut Costs. They Just Need The Right Incentives. Avant-garde has also written articles in JAMA, such as an Evaluation of Outcomes Under Bundled Payments for Joint Replacements.
Hospitals that act now to prepare for TEAM will not only excel in the program but also position themselves as leaders in delivering high-quality, cost-efficient care. For patients, this means better coordinated care and improved outcomes. For hospitals, it ensures long-term financial sustainability and readiness for the evolving payment landscape.
Dr. Porter Jones is the Vice President of Clinical Transformation at Avant-garde Health, specializing in value-based care strategies that align clinical outcomes with financial sustainability. He partners with hospitals and physicians to implement data-driven solutions that enhance efficiency and improve patient care.
Derek Haas, MBA, is the CEO and founder of Avant-garde Health. Avant-garde’s analytics software provides health systems, surgeons, and ASCs with comprehensive insight into their surgical care and empowers them to improve their profitability and care quality.
Ann Conrath is the Director of Sales at Avant-garde Health, leveraging extensive healthcare industry experience to advance value-based care through innovative technology and operational strategies.
Contact Ann@avantgardehealth.com to learn more
