Healthcare Operations & Workforce

Over the past 30 days, CMS—under new leadership—has accelerated the rollout of the Transforming Episode Accountability Model (TEAM), reinstating mandatory bundled payments for high-volume surgical episodes with explicit downside risk for hospitals and ACOs. Structural shifts include mandated participation, revised discount rates (e.g., 2% for LEJR, SHFFT, and spinal fusion; 1.5% for CABG and major bowel), and a heightened reliance on composite quality scores as determinants of payment and risk, signaling a more aggressive federal push toward value-based care as the dominant Medicare payment paradigm. These changes force providers and payers to quickly adapt operations, workforce planning, and risk management approaches—or risk significant financial and strategic losses in the evolving landscape where CMS is [“all-in on using the ‘big stick’”](https://news.google.com/rss/articles/CBMiwwFBVV95cUxNOU1GcnZHVWxTXzVwdVE2Y1BCQWZaTDZCaDNoMU5wMWZRRHcxVXVzMjVuN0hPanU5UEJNZGdVVDY2Tk9zOUJOYzNsR2plTnlDa1g0WHJoS0ozZ3A1b2lFOUtDLUhHbHFKWFVDSjl5OFVBZnlVb1UyaVhsdVJBeFBpcUEwVUJZTGktakNi