The CMS is set to launch the Transforming Episode Accountability Model (TEAM) in 2026. The TEAM framework is a mandatory, bundled, episode-based payment model that shifts accountability to hospitals for both cost and quality outcomes. For nurse leaders, TEAM will introduce a familiar but sharpened challenge: how to deliver coordinated, high-quality, patient-centered care across increasingly complex clinical episodes — all while under new financial scrutiny.
TEAM will apply to five high-volume surgical procedures: lower-extremity joint replacement, surgical hip femur fracture treatment, spinal fusion, coronary artery bypass graft, and major bowel procedures. Hospitals in selected geographic areas will be responsible for patient outcomes from admission through 30 days post discharge — a shift that will demand nurse-led care coordination and cross-continuum care delivery across settings.
Unlike voluntary bundled payment models, TEAM isn’t just a billing or compliance exercise. It is a care redesign initiative — and nurse leaders will be at the center of it. Although finance and compliance teams may manage reporting, it is nurses who will operationalize care across settings, who will close quality gaps, and who will directly influence patient recovery. Included in the responsibilities will be support of hospital discharge best practices that reduce avoidable complications and improve continuity of care.
To meet the new expectations, many organizations will have to invest in nurse training for value-based care by ensuring frontline teams have the tools and workflows needed to succeed under TEAM.
CMS will assign target prices and assess performance based on actual spending and quality measures. If hospitals exceed their targets, CMS may recoup their money. If they come in under their target — while maintaining quality — they may earn bonus payments.
The bottom line? Nurse leaders will play key roles in driving value-based nursing care transformation — and will have the opportunity to lead it.
How nurse leaders can prepare for TEAM
1. Redesign care delivery models for episode-based alignment
First, nurse leaders must ask, “Does our current care delivery structure support consistent, efficient episode management?” because TEAM will demand more than strong inpatient care; it will require seamless coordination across the full surgical episode — from preop planning through 30 days post-discharge.
Preparing for the change will require that organizations:
- Reevaluate surgical units’ nurse staffing models to better support interdisciplinary bedside rounds and timely discharge planning.
- Embed episode-specific care pathways into nurse-led shift handoffs and patient rounding routines.
- Align clinical workflows to reduce length of stay and prevent avoidable readmissions.
- Tighten coordination between inpatient nursing, case management, and post-acute teams to improve outcomes and continuity.
Even at hospitals already using evidence-based protocols, TEAM may call for new, higher levels of consistency, communication, and accountability across settings.
2. Activate nurses as care coordinators — not just as caregivers
TEAM will reinforce a fact nurses already know: recovery doesn’t stop at the hospital door. That’s why nurse leaders should guide efforts to strengthen care transitions beginning the moment a patient is admitted.
Key priorities are:
- Fostering day one collaboration between nurses and case managers for discharge planning
- Standardizing discharge education across nursing teams for patients undergoing TEAM-eligible procedures
- Creating feedback loops with skilled nursing facilities, home health agencies, and ambulatory providers — potentially through nurse-led outreach or electronic medical record alerts.
TEAM is not about adding more tasks; it is about building repeatable, proactive systems that reduce care variation and enable nurses to intervene before issues lead to readmissions.
3. Reskill and upskill nursing teams for value-based care
For many frontline nurses, value-based care models like TEAM can feel abstract — especially when success is defined by metrics and not moments of care. Nurse leaders can bridge that gap by connecting daily practice to performance outcomes in ways that feel real and relevant. To achieve the connection, leaders should:
- Educate staff on how individual contributions affect TEAM-related outcomes such as length of stay, readmissions, and episode costs
- Incorporate value-based thinking into new-nurse orientation and continuing education (e.g., “What’s my role in reducing length of stay?”)
- Provide real-time visibility into team-level performance so units can adjust proactively.
When nurses see the direct impact of their handoffs on readmissions, value-based care stops being about CMS and starts being about patients.
The importance of nurse leadership under TEAM
Nurse leaders may not be the ones who will set reimbursement rates or file CMS reports, but they will shape the care that decides whether TEAM succeeds. From redesigning workflows to improving care transitions and training staff, nurse leaders’ decisions will directly affect costs, quality, and patient outcomes.
The opportunity here involves not only compliance but also leadership, and nurse executives who position their teams now will be ready not only for TEAM in 2026 but also for whatever comes afterward.
