Where your hospital stands in CMS's TEAM model

TEAM, the Transforming Episode Accountability Model, is a Medicare program that runs from 2026 through 2030. Hospitals in the markets CMS picked have to take part. For five surgeries, Medicare adds up nearly everything it pays from the hospital stay or outpatient surgery until 30 days after the patient leaves the hospital, and compares the total with a budget called the target price. The five are coronary bypass, major bowel surgery, spinal fusion, joint replacement and hip or femur fracture repair. Only patients in traditional Medicare count. Medicare Advantage patients do not.

For the hospital's finances, yes. A dot further right means the stay uses more of the target, so less is left for the doctors and the 30 days after discharge, and a nursing home stay or a readmission is more likely to push the hospital over. It says nothing about quality of care. Sicker, more complex patients can push a dot right, and CMS raises the target for hospitals with sicker patients, which would move their dots left.

Not by itself. Above 100% means the stay alone, on average, cost more than the whole target. Four of the 1,539 hospital and surgery pairs are there. All four rest on 13 to 80 stays, so a handful of cases that cost many times the usual amount can lift the average, and TEAM limits how much one extreme case counts. Public data can't apply that limit. What a hospital owes depends on its whole year across all five surgeries.

From January 2027, a TEAM hospital pays back spending above its targets, up to 20% of its total target dollars for the year, unless it qualifies for a lower-risk option and chooses it. These options are called tracks, and the 20% limit belongs to Track 3. Track 2, with a 5% limit, is open to safety-net, rural and some other small hospitals. Safety-net hospitals, which serve many low-income patients, can also stay in Track 1 through 2028, which pays bonuses and never asks for money back. At settlement, CMS adds up gains and losses across all of a hospital's TEAM cases for the year and adjusts the result for quality.

Yes, because TEAM does. Medicare pays more for the same surgery where local wages are high. It also pays extra to teaching hospitals, to hospitals that serve many low-income patients and to some small rural hospitals. Hospitals keep that money, but TEAM leaves it out when it compares spending with the target. A hospital in San Francisco and one in rural Ohio are measured in the same dollars. Medicare's extra payments for unusually expensive cases stay in, as they do in TEAM.

Nothing. Every number in it comes from files CMS publishes.

No. We only need your hospital's name. The report uses public CMS files: the TEAM participant list, the 2026 target prices, Medicare's inpatient payments by hospital, Medicare's hospital payment rate files and Care Compare.

No. Public files stop at discharge, so they miss where patients go next, what that care costs and who is readmitted. They also leave out outpatient surgery and each hospital's own adjusted target. A TEAM hospital gets its own targets from CMS, and it can ask for the Medicare claims for its TEAM patients. Those claims show the rest of the episode.

A hospital gets a dot only for a surgery with 11 or more traditional Medicare stays in the 2024 public file. Smaller counts are hidden, and the file leaves out outpatient surgery. That leaves 197 of the 720 hospitals on CMS's June 2026 list with no dot. All of them are in the search, and the report still covers the TEAM hospitals in their market. Spinal fusion has one more gap. In October 2024 the codes for most lower-back fusions changed, and TEAM only prices the new codes, so stays from January to September 2024 are left out. Where that affects a hospital, its numbers say so.