TEAM Overview
What is the time period that TEAM will run?
2026 - 2030
How many years are included in the baseline data used to calculate TEAM target prices?
3 Years
How many reconciliations will each performance year undergo?
How many more clinical episode categories are included in BPCI Advanced compared to TEAM?
29 (34 in BPCI Advanced, 5 in TEAM)
Who is the current Director of the CMS Innovation Center?
Abe Sutton
What are the five clinical episodes in TEAM?
CABG, Major Bowel Procedure, LEJR, SHFFT, Spinal Fusion
What is the discount factor applied to the target prices?
1.5% (CABG/Major Bowel)
2.0% (LEJR/SHFFT/Spinal Fusion)
What are the CQS adjustment percentages for Track 1?
10% Positive, No Impact Negative
What are the two different quality sets that a BPCI Advanced participant can elect into?
Administrative or Alternative
The Affordable Care Act (2010)
Which clinical episodes can trigger episodes in both inpatient and outpatient hospital settings?
LEJR and Spinal Fusion
What regions are used to create the Regional Target Price?
9 US Census Divisions
What is appled to ensure a participant's reconciliation payment is not too significant (positive or negative)?
Stop-Loss and Stop-Gain
What is the name of the family of clinical episodes that a participant could elect into in BPCI Advanced?
Clinical Episode Service Line Groups (CESGLs)
Who is the group director of the Research & Rapid-Cycle Evaluation Group (RREG)?
Noemi Rudolph
In what Performance Year are Safety Net Hospitals required to take on downside risk?
Performance Year 4 (2029)
What adjustment is performed to ensure target prices are capturing actual episode spend during the performance year?
Retrospective Trend
Which Participation track includes a higher percentage impact of CQS for negative reconciliation amounts relative to positive reconciliation amounts?
Track 2
What is the name of an organization that could bear risk in BPCI Advanced on behalf of other providers?
Convener
What is an episode of care called when it is constructed for an ACO using only their aligned beneficiaries?
Shadow Bundle
How many quality measures will Performance Year 1 include?
3 (All Cause Readmission, Hip/Knee PRO, Patient Safety/Adverse Event Composite Measure)
What does the High-Cost Outlier cap do to the target price?
It caps episode spending at the 99th percentile at the episode type and regional level to protect participants from especially high payment episodes.
What does Acumen look for when evaluating post-episode spending?
Monitors spending for 30-days after episodes end, looking for participants with post-episode spend >3 std dev above the regional average
What is the difference between an episode of care and a bundled payment?
Episode of Care = Total cost of Care for period of time (Episode) compared to a target/benchmark
Bundled Payment = Total all inclusive payment for set determined group of services
What is the biggest difference between ACO REACH and the Medicare Shared Savings Program?
REACH is a model, SSP is a program