Medicare remains bullish on risk sharing to reduce federal costs and, in particular, has shown interest in engaging specialists in accountable care.   The BPCI program, which focused on specialists, reduced delivery costs from the participant perspective but overspent on incentives and administration.  CMS has learned from its prior mistakes and expects TEAM to create net savings this time around.

When it comes to CMS TEAM, knowledge is power.  A Brandeis University analysis projected that two-thirds of hospitals will lose revenue under TEAM at current performance levels.  The reality of benchmarking and pricing methodologies is that some organizations will enter the TEAM program with headwinds and others, tailwinds.   For some hospitals the dollars involved are quite meaningful.   

Clarify is strongly encouraging all our provider partners assigned to the CMS TEAM program to review their historical performance data to understand whether they are currently set up to over- or underperform their benchmark rates and to estimate the ROI from programmatically addressing their performance.  This analysis makes picking a track straightforward.  

There are some organizations who can do very little and expect to do OK.  Most others, however, will find the return is large enough to be worth some attention.  And some will have a low-risk path to significant revenue increases through TEAM. 

As hospitals and health systems prepare for the upcoming CMS Transforming Episode Accountability Model (TEAM), one of the most strategic decisions they’ll face is deceptively simple: Which track should we choose?

While selecting a track might seem like an administrative step, it’s far more than checking a box. The track you choose determines your financial exposure, your potential for shared savings, and the level of care coordination and operational transformation required to succeed.

At Clarify Health, we believe that having the right data and insights at your fingertips is the difference between entering a track with confidence or stepping into risk unprepared.

Much like previous models, CMS TEAM is designed with multiple participation tracks that vary in their levels of financial risk and reward. For example, an organization might choose a one-sided risk track, where they only share in savings but aren’t responsible for paying back overages. Others might opt for a two-sided risk track, where they take on both upside and downside risk in exchange for greater potential rewards.

The intent is clear: CMS wants hospitals to build experience in managing financial accountability for episode-based care and eventually take on more risk as they gain confidence and capabilities.

But here’s the reality:
Choosing the right track requires more than optimism about improvement. It demands a deep understanding of your historic cost and quality performance, your episode mix, your market dynamics, and the strength of your post-acute and specialty care networks.

At Clarify Health, we’ve seen firsthand how hospitals that enter a higher-risk track without the right insight and preparation often struggle to capture savings or, worse, face unexpected penalties.

So, how do you know which track is right for you? It starts with answering key questions:

• What is your baseline cost performance by episode?
• Where do you have variation and leakage?
• How aligned are your care teams, specialists, and post-acute partners?
• Do you have actionable strategies to close performance gaps before downside risk kicks in?

With the right episode-based analytics, these questions become less daunting. You move from rough estimates to clear, data-backed answers that inform your strategy.

Clarify’s episode-based intelligence solutions are purpose-built to equip hospitals with the insight they need to choose the track that best fits their capabilities and growth goals.

Our upcoming CMS TEAM analytics suite will help hospitals:

Quantify opportunity and exposure. Use historical claims and benchmarks to project how you’d perform under different tracks — before you sign on the dotted line.

Pinpoint variation drivers. Identify exactly where cost and quality performance could derail your episode targets — from high-cost drivers like SNF and IRF utilization to readmissions and ED visits — so you can address gaps proactively and capture savings.

Align your network. Build alignment with the highest performing post-acute providers, ensuring your network delivers consistently high-quality, cost-efficient care that supports success under shared risk.

Simulate scenarios. Run ‘what-if’ analyses to test your readiness for higher levels of downside risk — and make informed decisions about when to take on more accountability.

At its core, CMS TEAM isn’t just about managing cost for a single episode — it’s about transforming how hospitals think about care coordination, network performance, and long-term sustainability.

When you choose the right track, you give your organization the breathing room to learn, grow, and mature your capabilities without unnecessary financial stress. And with Clarify’s data-driven insights, you have the confidence that your decision is rooted in facts — not guesswork.

As the 2026 launch approaches, now is the time to take stock of your episode performance and plan the smartest path forward. We’re here to help you succeed every step of the way.

Clarify’s free Opportunity Analysis can show you exactly what your financial exposure looks like going into the CMS TEAM performance year. See where you stand, choose the right track, and move forward with confidence.

Explore the Opportunity Analysis to get started.

Want to learn more about how analytics can help your hospital succeed under CMS TEAM? Explore Clarify Health’s episode-based analytics.