Survey: Most providers not ready for TEAM bundled payments

Knowledge chaos plagues TEAM

The biggest barriers to implementing quality initiatives, such as TEAM, relate to a concept researchers call "knowledge chaos."

Knowledge chaos occurs when providers encounter fragmented, inaccessible knowledge, researchers explained. Clinical knowledge may exist in silos because data systems cannot share information, making it nearly impossible for clinicians to access the information they need when they need it, they elaborated.

 About 76% of clinical quality leaders pointed to barriers related to this idea of knowledge chaos, according to the survey. Of the respondents, 30% cited fragmented systems and information storage, 29% said insufficient training and onboarding and 17% selected a lack of visibility into staff usage of protocols or guidance.

"Low performers," defined as quality leaders whose initiatives succeeded less than 60% of the time and represented about 20% of respondents, felt the effects of knowledge chaos more acutely, the survey added. About half of these low performers cited insufficient training and onboarding processes as their most significant barrier, a rate nearly double that of high performers.

Other barriers to implementing quality initiatives included staff resistance to change (15%) and competing priorities (9%).

What sets high performers apart

The quality improvement providers need to succeed at initiatives like TEAM require the right combination of culture and technology, researchers stated.

The survey revealed similarities among high performers who responded to it. Those similarities included less resistance to change, the use of digital tools for knowledge dissemination and a feeling of empowerment to affect change within their organizations.

Additionally, high performers expressed optimism about the use of artificial intelligence (AI), particularly its potential to counter clinician burnout.

High performers are more likely to use more advanced technologies compared to low performers. In fact, low performers were three times more likely to store protocols in physical binders, the survey found. Meanwhile, 64% of high performers used a knowledge or learning management system, making them 42% more likely to use one of these systems compared to low performers.

High performers were also nine times more likely to say AI will significantly improve quality, although 61% of all respondents were optimistic about AI's potential in quality improvement. The main difference is that 57% of high performers already extensively leverage AI for quality improvement versus just 5% of low performers.

Notably, 99% respondents who couldn't even measure their quality improvement success, marking them as performance outliers, said they have no plans for AI implementation for quality improvement.

TEAM requirements are on the horizon

The clock is ticking for hospitals having to participate in TEAM, and less than a quarter of providers feel prepared to take on the new bundled payment model.

Providers should consider prioritizing readiness for the model. The survey showed that just 28% have TEAM in their top three priorities for 2026, despite CMS preparing to hold them accountable not only for what happens during a patient's stay, but also for the quality and cost of care 30 days after discharge.

Researchers advised providers to disseminate protocols for consistent application across the organization. A knowledge or learning management system can help to get this information to clinicians when and where they need it.

Staff education is also key, researchers said. Education needs to happen at the point of care and beyond the one-time orientation.

Additionally, researchers recommended regulatory agility versus compliance. Provider systems need to absorb new requirements without the massive manual effort, they said.

Jacqueline LaPointe is a graduate of Brandeis University and King's College London. She has been writing about healthcare finance and revenue cycle management since 2016.