Transforming Episode Accountability Model (TEAM)

Penn Medicine Princeton Health has been selected to participate in a Centers for Medicare & Medicaid Services (CMS) 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 can choose to work with healthcare entities, such as skilled nursing facilities, home health agencies, doctors, and other healthcare workers or organizations who are also helping Medicare patients. These helpers are called “TEAM collaborators”. TEAM participants can set up financial arrangements to share extra money they get from Medicare with TEAM collaborators.

The list below are those health care providers who have established a collaborator agreement with Penn Medicine Princeton Health as part of the TEAM program.

Princeton Orthopaedic Associates

Princeton Bone and Joint, LLC

Princeton Brain & Spine Care

Princeton Surgical Associates, PA

Clinical Health Care Associates of New Jersey

CMS TEAM Policy for Selection Criteria of Collaborators

Submitted by: Craig Gronczewski, CMO

Administrative Approval:

  • Chief Executive Officer, Penn Medicine Princeton Health
  • Chief Medical Officer, Penn Medicine Princeton Health

Distribution: Administrative

Committee Approval:

  • CEQI
  • BOT Quality Committee

Effective Date: 1/1/2026
Next Review date:
01/01/2029
Supercedes:
N/A

Purpose

The purpose of this policy is to identify criteria for selection of physicians with whom PMPH (PMPH) will enter into a collaborator agreement for the provision of care for Transforming Episode Accountability Model (TEAM) eligible patients and determining the quality criteria to be met to be eligible to receive gain sharing payments.

Collaborating Physician Selection

  • Collaborating Physician selection is based on the Physician Group Practices that are actively involved with program design, evaluation of delivery of care as well as care coordination for PMPH TEAM patients.
  • Collaborating Physician participation is voluntary and without penalty for nonparticipation.
  • Collaborating Physicians must be active members of the PMPH Medical Staff and possess qualifications for and maintenance of privileges to perform CMS TEAM eligible anchor procedures/surgeries and/or manage CMS TEAM eligible patients across the continuum of care for these episodes.
  • Collaborating Physician Selection is not based directly or indirectly on the volume or value of past or anticipated referrals.

Quality Criteria for physician providers

Quality criteria for physician providers are documented specifically in the sharing arrangement. They may include but are not limited to the following:

  • Attendance by the Collaborating Physician, or a physician delegated by the Collaborating Practice, at CMS TEAM Clinical Governance meetings, to be held bi-monthly (every other month) between PMPH TEAM administrators and Collaborating Practices. Meeting dates may be adjusted to less frequent intervals (e.g. quarterly) to align with CMS data distribution.
  • Collaborating Physician readmission rate of all CMS TEAM attributable encounters of < 10%. The readmission rate will be calculated using data provided by CMS specifically for the TEAM program.
  • Collaborating Physician infection rate of all CMS TEAM attributable encounters of < 5%. The infection rate will be calculated using data from the Hospital’s Infection Control Department.
  • Collaborating Physician PSI-9 attributable incidents to be ≤1. The PSI-9 rate will be calculated using data from the Hospital’s Performance Improvement Department.

Procedure

In addition, Collaborating Physician and Collaborating Practice agree to:

  • Participate in performance review meetings as requested.
  • Maintain documentation supporting clinical quality improvement efforts.
  • Meet or exceed established thresholds relative to baseline performance for the applicable quality measures; and
  • Collaborate with the PMPH to implement quality improvement plans when metrics fall below CMS benchmarks.
  • Cooperate with data collection, reporting, and validation activities necessary to support the PMPH’s compliance with CMS reporting and public transparency obligations.
  • Comply with all applicable requirements, regulations, and guidance issued by the Centers for Medicare & Medicaid Services (CMS), including any current or future requirements applicable to participation in the program.

References: Transforming Episode Accountability Model (TEAM) - 42 C.F.R. § 512.100 et seq. (2025)

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