On Demand: TEAM Ready or Not? CABG Program Readiness in a New Era of Episode Accountability-Presentation Slides

Presentation Slides

Pdf Summary

The presentation by Nicole Knight and Katie Willerick of MedAxiom outlines the readiness required for Coronary Artery Bypass Graft (CABG) programs under CMS’s Transforming Episode Accountability Model (TEAM), a mandatory episode-based payment model effective from 2026 through 2030. TEAM demands hospitals participate in managing care episodes around specified surgeries, including CABG, with an emphasis on coordinated, high-quality care and financial accountability.<br /><br />TEAM introduces graduated financial risk tracks (1-3) with varying upside and downside caps to ease hospitals into full-risk participation. The model covers all Medicare fee-for-service patients for the episode period, typically 30 days post-discharge, including inpatient services, physician services, post-acute care, therapies, and medications. Pricing uses regional data, risk adjustments, discounts, and trend normalization to set target prices, with ongoing CMS monitoring and compliance reviews.<br /><br />CABG care variation—in length of stay, complications, ICU use, discharge disposition, readmissions, and post-acute utilization—makes it a high-impact episode requiring multidisciplinary coordination, including cardiothoracic surgery, cardiology, nursing, case management, and post-acute partners. Readiness spans five domains: clinical standardization, operational execution, post-acute strategy, data & measurement, and governance & accountability.<br /><br />Key components for readiness include standardized care pathways, discharge criteria, predictable staffing, post-discharge follow-up within 7–14 days, preferred post-acute networks, actionable data visibility (e.g., length of stay, readmission rates, complications), and structured governance with clear ownership and decision rights.<br /><br />Common blind spots hindering readiness are overconfidence in outcomes without addressing variation, inconsistent discharge planning, lack of ownership of post-acute care performance, non-actionable data, and governance meetings that lack decision-making authority.<br /><br />A 30/60/90-day roadmap guides program development from establishing governance and standardizing discharge to building dashboards, reducing variation, expanding networks, and embedding episode-based management. The overall message stresses that TEAM is more than a financial challenge—it requires integrated clinical, operational, data, and governance efforts to optimize patient outcomes and financial performance in the new era of episode accountability.

Keywords

Coronary Artery Bypass Graft (CABG)

CMS Transforming Episode Accountability Model (TEAM)

episode-based payment model

graduated financial risk tracks

Medicare fee-for-service

clinical standardization

post-acute care strategy

data measurement and analytics

governance and accountability

multidisciplinary care coordination