The Bone Health Clinic
CMS Value-Based Care · A Hospital Leader's Field Guide

Is Your Hospital READY for TEAM and CJR-X?

Medicare's move to episode-based accountability is here. TEAM is mandatory, it started January 2026, and it puts your hospital on the hook for the cost and quality of an entire surgical episode. CJR-X is what comes next. Here is what it actually means, and how to come out ahead.

Mandatory · 2026–2030 ~741 hospitals Surgery + 30 days 5 episode types

If your hospital was selected for TEAM, the model is not optional and the clock is already running.

Most of the explainers you will find restate the CMS fact sheet. This guide does something different. It walks through the model in plain language, shows you exactly where surgical episodes lose money and quality points, and then lays out a concrete way to protect the episode and share in the savings.

Read it top to bottom in about ten minutes. Part one explains the model. Part two shows where episodes break. Part three is how a focused surgical optimization program turns that risk into margin.

Free Download

The READY Framework

A hospital administrator's five-move framework for TEAM and CJR-X. Take it to your next leadership meeting.

Part I

Understand the Model

No jargon. Just what TEAM is, who it touches, and how the money actually moves.
The Basics

What TEAM is, in one breath

TEAM is a five-year, mandatory, episode-based payment model running January 2026 through December 2030. CMS selected roughly 741 hospitals by geographic region. If you were selected, you participate. There is no opt-out.

An "episode" begins with a qualifying surgery and runs through 30 days after the patient leaves the hospital. You keep billing Medicare fee-for-service as you always have. At the end, CMS compares your total spending across that episode against a target price.

The shift: you are no longer paid only for the surgery. You are now accountable for everything that happens to that patient for 30 days after discharge, including care you do not deliver yourself.
Scope

The five surgical episodes

TEAM covers five high-volume, high-spend procedure families:

  • Lower extremity joint replacement (hip and knee)
  • Surgical hip and femur fracture treatment
  • Spinal fusion
  • Coronary artery bypass graft
  • Major bowel procedure

Three of the five are orthopedic. For most participating hospitals, joint replacement and hip fracture are the highest-volume episodes, which makes them the fastest place to win or lose under the model.

Risk Ladder

Tracks 1, 2, and 3

TEAM eases hospitals into risk through three tracks:

  • Track 1: upside only, no downside, with savings capped around 10 percent. Available for year one to all participants, and up to three years for safety-net hospitals.
  • Track 2: two-sided but lower stakes, gains and losses capped around 5 to 10 percent, for certain participants such as safety-net and rural hospitals, years two through five.
  • Track 3: full two-sided risk, gains and losses capped at 20 percent, years one through five.
Why it matters now: 2026 is upside-only for most hospitals. That makes this the cheapest year you will ever have to build the muscle. Downside risk arrives in 2027. The habits you set this year are the ones you carry into the years that can cost you.
The Money

Target price, then earn or owe

CMS sets a target price built from non-excluded Medicare Part A and Part B items and services across the episode, adjusted regionally and for quality.

At reconciliation, the math is simple in direction:

  • Spend below the target price, and you may earn a payment from CMS.
  • Spend above the target price, and you may owe CMS a repayment.

Both sides are adjusted by your quality performance. Strong quality protects and amplifies savings. Weak quality erodes them, even when your costs look good.

Part II

Where Episodes Leak

The target price is fixed. Your spending is not. Almost all of the variation lives in the same handful of places.
The Whole Game

The 30-day window is where you win or lose

The surgery itself is largely standardized and predictable. The cost variation that decides whether you beat the target price happens in the 30 days after discharge, in care you historically have not controlled.

Put plainly: two surgeons can perform an identical operation, and the episodes can differ by thousands of dollars based entirely on what happens to the patient after they leave the building.

The Leak Points

Four places episodes bleed

  • Post-acute care. Skilled nursing, inpatient rehab, and home health are the single largest swing factor. A patient sent to a SNF instead of home can add five figures to an episode.
  • Readmissions. An avoidable return to the hospital inside 30 days is both a cost hit and a quality hit.
  • Complications. Infections, blood transfusions, delirium, and falls each extend recovery and pull spending above target.
  • Fragmented handoffs. No one watching the patient between discharge and the first follow-up is how small problems become emergency department visits.
The pattern: every leak point above is a downstream consequence of how ready the patient was, and how closely they were watched. Both are addressable.
Quality + Referral

Two requirements that bite quietly

Two parts of TEAM are easy to underestimate:

  • The quality performance adjustment can shrink your earned savings or deepen what you owe. Patient-reported outcomes for joint replacement are part of the quality picture, and they are driven by how the patient was prepared and supported, not just the operation.
  • The primary-care referral mandate. TEAM requires participants to refer patients to primary care to support long-term outcomes. This is a deliberate signal: CMS wants the episode connected to lasting care, not treated as a one-time transaction.
The Gap

Pre-op optimization is usually incomplete

Most practices review some pre-operative metrics, but structured prehabilitation is rare, and clearance is not the same as optimization. Without a single process owner accountable for the whole picture, modifiable risks routinely slip through.

The result is a patient you are now accountable for who clears the usual checks yet still carries modifiable risk factors, the kind that quietly raise the odds of a complication, a longer stay, a SNF discharge, or a readmission.

The opportunity: the two windows that pay under TEAM are pre-operative optimization and 30-day monitoring. They are also the two windows almost no hospital systematically and completely owns.
The Turn

You cannot change the target price. You can change the episode.

Everything above is the problem. What follows is a focused, guideline-first program built to get patients to surgery ready and keep them safe through the 30-day window, so the episode comes in under target with the quality scores to match.

Part III

How TBHC Helps You Win

The Bone Health Clinic operates a surgical optimization program designed around the exact levers that move a TEAM episode. Here is how it works.
The Front Door

The Surgical Optimization Clinic

TBHC stands up a structured pre-operative optimization visit for your elective surgical patients. One coordinated encounter screens every modifiable risk factor that drives episode cost and quality, flags what needs fixing, and sends the patient into surgery genuinely ready.

The model is deliberately clean: TBHC screens, flags, and counsels. The patient's own primary care and specialists treat. That keeps your referral relationships intact and keeps the program inside its lane.

Built for all five episodes: orthopedic encounters drive roughly 85 percent of episode volume, so that is where the program proves out fastest. But surgical optimization is surgical optimization. The clinic is positioned to ready patients across all five TEAM episodes, not just the orthopedic three.
Readiness Engine

Pre-operative optimization, built by someone who has lived it

This is the part most programs get wrong, and it is not something you buy off a shelf. TBHC's optimization protocol is guideline-driven and built by a practicing orthopedic surgeon who has stood on both sides of these episodes. It is a structured, step-by-step process, so every modifiable risk factor is actually evaluated against the guidelines and addressed before the patient ever reaches the operating room. Nothing gets checked off and forgotten. Nothing falls through.

The specifics are the program. What matters to you is the result.

The effect: fewer complications, shorter stays, more patients discharged home instead of to a SNF, and stronger quality scores, which is the whole ballgame under TEAM.
Disposition

Home is the plan

Because post-acute care is the largest cost swing in any episode, TBHC builds disposition planning in from the first visit. Expectation-setting, home-readiness, mobility confidence, and a monitored home recovery program move appropriate patients home instead of to a skilled nursing facility, safely.

A single SNF stay avoided can be the difference between an episode that earns and one that owes.

Episode Protection

We own the 30 days nobody else does

The 30-day post-discharge window is where episodes are decided, and it is the window almost no hospital actively owns. TBHC does. We hold concierge-level care through the full window, catching early warning signs and intervening before they become an emergency department visit or a readmission.

This is the leak point from Part II turned into something you control. The weeks that used to go unwatched become the weeks that protect your episode.

Inside Your Walls

We work within your system

The inpatient encounter is the other half of the episode, and you do not need a new vendor platform to fix it. TBHC works within your existing system, optimizing order sets, protocols, and best practices to tighten the inpatient stay for your highest-risk episodes.

It is institution-reviewed and built into how your teams already work, so the gains outlast any single patient.

Savings beyond the bundle: the same optimization lowers your cost of delivering care within the DRG itself, margin you keep on every case, with or without TEAM. The episode is where we start, not the only place the model pays. There are further streams we open once the core program is running.
Alignment

Economics that line up

TEAM holds the hospital accountable, but surgeons drive the behavior that decides the episode. Those two parties do not always speak the same language, and that is exactly the gap TBHC fills. An orthopedic surgeon who understands the perioperative environment from the inside is the right person to sit at both tables, translating between what the hospital needs to protect its margin and what surgeons need to protect their schedules, their outcomes, and their patients.

That shared credibility is what makes the alignment real instead of theoretical.

2026 is upside-only. Build the muscle now.

The cheapest year to get this right is the one with no downside risk. The Bone Health Clinic can stand up a surgical optimization program around your TEAM episodes, starting with the orthopedic procedures that move the needle fastest.

And TEAM is only the beginning. TEAM is the on-ramp. CJR-X is the highway. The same muscle you build now is what carries you onto it, and the hospitals that merge smoothly are the ones that started here. You will want to be one of them.