CMS Transforming Episode Accountability Model (TEAM)

Fairview Health Services hospitals (with the exception of Grand Itasca Clinic and Hospital) participate in a mandatory program called the "Transforming Episode Accountability Model" (TEAM). A CMS model is a trial program, and a way of testing how health care can be improved for people with Medicare and Medicaid. In this model, selected hospitals (referred to as "TEAM participants") will coordinate care for beneficiaries with original Medicare, who are undergoing certain surgical procedures included in the model. TEAM participants are accountable for the cost and quality of care from surgery through the first 30 days after you leave the hospital.

TEAM aims to improve the patient experience from surgery through recovery by supporting the coordination and transition of care between providers to reduce avoidable hospital readmissions.

The five surgical procedures in the model are:

• Lower extremity joint replacement
• Surgical hip femur fracture treatment
• Spinal fusion
• Coronary artery bypass graft
• Major bowel procedures

As we do today, TEAM hospitals work with other health care entities and organizations to provide patient care, such as skilled nursing facilities, home health agencies, doctors, and other healthcare workers and services. Under TEAM, we are required to notify you if there are any specific financial relationships related to the TEAM work between our hospitals and other healthcare entities/organizations which Medicare defines as a “TEAM collaborator”. At this time, Fairview has not made financial arrangements of this type with any TEAM collaborators.

If you are an Original Medicare beneficiary and have one of the procedures above at a participating Fairview hospital, you will have all the same Medicare benefits, rights, and protections under this model. Medicare will continue to cover all your medically necessary services. Individual beneficiaries cannot opt out of the model when they receive hospital services from a TEAM participant. As a Medicare beneficiary you will keep your freedom of choice and may seek care with a different hospital that is not a TEAM participant.

Health care providers and suppliers who are enrolled in Medicare and are TEAM participants will submit their Medicare claims as they always have. Even though Medicare may provide additional payments to a hospital that is a TEAM participant, the amount you pay will not change.