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The key to TEAM success in HME: Leveraging referral networks (part 1)
The Centers for Medicare & Medicaid Services (CMS) is rolling out the Transforming Episode Accountability Model (TEAM), a mandatory bundled payment program starting January 1, 2026.
Under the CMS TEAM model, acute care hospitals in 188 selected regions are TEAM participants required to take on financial risk for five surgical episodes:
- Lower extremity joint replacement (LEJR)
- Coronary artery bypass graft (CABG)
- Major bowel surgery (MBP)
- Surgical hip/femur fracture treatment (SHFFT)
- Spinal fusion (SF)
Importantly, CMS is allowing and encouraging these hospitals to develop partnerships with various other provider types, including HMEs. For HME specialists, this represents a unique and viable opportunity.
HMEs that proactively cultivate strong referral relationships with TEAM hospitals stand to secure patient volume, while those left out of these networks could see referrals dwindle.
In this blog series, we explore why referral networks are truly the key to success for HMEs in the new value-based care landscape.
Importance of referrals in the TEAM era
Value-based payment models like TEAM make hospital-HME partnerships more important than ever. Hospitals will be held accountable for patients’ post-acute outcomes and costs, so they are incentivized to steer discharges to high-quality HMEs that can help them succeed.
In past bundled payment programs, most hospitals formed preferred HME networks, essentially trading referral volume for assurances of better HME quality and lower costs.
We can expect the same under TEAM: participating hospitals are likely to create “high-value post-acute care networks” of top-performing HMEs and other providers. HMEs included in these networks benefit from a steady stream of referrals, while hospitals benefit by reducing complications, readmissions, and overall episode spending in the HME setting.
However, only HMEs that have forged strong relationships and demonstrated value will be invited to the table. In short, your HME’s referral network—or lack thereof—will directly impact your ability to participate in TEAM and eventually thrive under value-based care.
Additional benefits for DMEs participating in TEAM include:
Increased referral and stronger hospital partnership opportunities:
TEAM hospitals must partner with quality, proven post-acute providers. Collaborating under TEAM fosters deeper integration with hospitals, improving or generating new referral relationships and care coordination activities.
Stronger market position and strategic positioning:
Being a valued TEAM partner elevates your DME’s visibility and credibility. This can result in long-term relationships with hospitals, ACOs, and payors.
We’ll explore two scenarios throughout this blog series. This blog will focus on HMEs already embedded in hospital networks.
Established referral networks scenario: Leverage and align
If your HME already has an established referral network with one or more hospitals, you are starting from a position of strength. You likely have a history of discharging patients from those hospitals and perhaps even a reputation for good outcomes.
Under TEAM, you’ll want to leverage these existing hospital relationships for alignment with the model’s goals. Begin by talking with your hospital referral partners about TEAM. Express your commitment in becoming a member of their TEAM post-acute network and ask how you can best support their objectives, such as reducing readmissions or post-acute costs.
Other key TEAM best practices include:
- A focus on reducing unnecessary ED visits and hospitalizations
- Encouraging appropriate use of alternate care settings
- Improving care coordination across the healthcare continuum
Since TEAM is mandatory for those hospitals, they will be actively redesigning care pathways and selecting post-acute collaborators, so make sure your HME is top of mind.
Strengthen your hospital appeal through transparency and HME data
Hospitals value partners who are forthcoming about performance. Share your patient outcome metrics openly. For example, your 30-day hospital readmission rate, average length of stay, patient satisfaction scores, and any relevant quality awards.
By maintaining transparency about patient outcomes, you build trust and prove that you’re serious about improvement. Hospitals in TEAM will be laser-focused on cost and quality data.
If you demonstrate that you are equally data-driven (regularly reporting outcomes and using that information to improve care), you make it easy for hospitals to keep referring to you. Remember that under TEAM’s rules, hospitals can even use certain waivers (like the three-day stay waiver), but only with HMEs that meet quality thresholds.
This is critical because TEAM episodes cover hospital discharge and a 30-day post-acute period—including DME delivered at home. If patients bypass SNF admission and go directly home, hospitals still need to ensure DME is set up promptly and appropriately.
DME providers matter because they fill the same post-acute role when patients are sent home instead of to an SNF.
In other words, your quality data is your currency for continuing the partnership.
Key strategies for established referral networks
To solidify your value to hospital partners, consider these tactics:
Maintain full transparency on outcomes.
Proactively provide hospitals with reports on your HME’s performance (for example, rehab progress, timely delivery and proper equipment usage, discharge to home rates, keeping patients in the home, reductions in ED visits and readmissions).
Regular joint quality meetings or scorecards can highlight that your outcomes align with (or exceed) hospital benchmarks.
This openness reassures hospitals that there will be no surprises when they send patients your way, and it facilitates collaborative problem-solving if any metrics slip.
Leverage predictive analytics and clinical intelligence.
If you have tools in your tech stack to help predict risk (for example, identifying which new admissions are at high risk for rehospitalization or complications), use them and let your hospital partners know you do.
Applying clinical intelligence software can help your team intervene early to prevent declines, thereby improving outcomes. When hospitals see that your HME uses data to actively manage care (for example, flagging at-risk patients for extra monitoring), they’ll recognize a partner that can help drive down avoidable hospital readmissions. In the context of TEAM, this directly supports the hospital’s financial success, creating a win-win scenario.
Communicate your capabilities aligned with TEAM goals.
Make it a point to update your hospital partners about any new capabilities, programs, or investments your HME has made that contribute to better episode outcomes. For example, if you’ve launched a cardiac recovery program, hired a wound care specialist, or adopted a new care coordination platform, let the hospitals know.
Emphasize how these enhancements address key TEAM metrics like reducing infection rates or improving functional outcomes. By continually sharing updates that highlight your HME’s alignment with TEAM objectives, you reinforce that keeping you in their preferred network and top of mind will help them succeed in the mandatory model.
With these strategies, HMEs that already enjoy a strong referral stream can further cement their status as an indispensable partner. Your goal is to be so aligned and communicative that the hospital would never consider excluding you from their high-value network.
In fact, you want to be the HME that hospital case managers immediately think of when a TEAM surgical patient needs post-acute care. By demonstrating transparency, analytical readiness, and constant improvement, you can leverage your existing network into a formal TEAM collaboration that yields shared savings and sustained referrals.
Ready to position yourself as a valued TEAM partner? Brightree can help you get there.
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Jim Chiakulas
Jim is an experienced healthcare leader with deep expertise in value-based care and population health. He has worked across a range of market segments, giving him a comprehensive understanding of the healthcare landscape.
At Resmed, Jim focuses on building and nurturing payor and strategic partner relationships. He identifies opportunities to guide customers through the complexities of payor and payor-intermediary landscapes while demonstrating the value our providers and partners consistently deliver to payors and stakeholders across all business verticals.
Brightree provide solutions to post-acute care providers (HME, DME & pharmacy home infusion).
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