Comparison
CMS TEAM VS CJR
TheComprehensive Care for Joint Replacement (CJR) Model was CMS's first mandatory bundled-payment program, running from 2016 to 2024 and covering hip, knee, and hip-fracture procedures with a 90-day post-discharge episode. TheCMS Transforming Episode Accountability Model (TEAM) is its successor — also mandatory, but coveringfive surgical episode types with a30-day window and athree-track risk structure that gives hospitals an on-ramp. Most former CJR participants are now in TEAM.
Side-by-Side
| Attribute | CMS TEAM | CJR |
|---|---|---|
| Participation | Mandatory For 741 Selected Acute-Care Hospitals | Mandatory For Hospitals In Selected Msas (~470 At Peak) |
| Start Date | January 1, 2026 | April 1, 2016 |
| Duration | 5 Performance Years (2026–2030) | 8 Performance Years (Concluded December 31, 2024) |
| Episode Types | 5 Surgical: CABG, LEJR, Major Bowel, SHFFT, Spinal Fusion | 2 Surgical: Lower Extremity Joint Replacement (Hip/knee) And SHFFT |
| Episode Length | 30 Days Post-Discharge | 90 Days Post-Discharge |
| Risk Structure | 3 Tracks: Track 1 (No Downside Risk), Track 2 (Lower), Track 3 (Full Risk) | 1 Track With Downside Risk Phasing In Over Time |
| Quality Measurement | Composite Quality Score (CQS) — 6 Measures | CJR-Specific Composite Quality Measure Including THA/TKA PRO-PM |
| Safety-Net Flexibility | Up To 3 Years In Track 1 For Safety-Net Hospitals | Limited Flexibility; No Extended On-Ramp |
| Geographic Scope | Selected Core Based Statistical Areas (Cbsas) | Selected Metropolitan Statistical Areas (Msas) |
| Episode Anchor | Day Of Qualifying Surgical Procedure | Day Of Admission For Qualifying Procedure |
| Outcome | In Progress — First Reconciliation Report 2027 | Completed. CMS Reported Overall Cost Reductions And Quality Maintenance. |
Common Questions
Did CJR end before TEAM started?
Yes. The Comprehensive Care for Joint Replacement (CJR) model concluded on December 31, 2024 after eight performance years. The CMS TEAM Model began January 1, 2026, with a one-year gap between programs.
If our hospital was in CJR, are we in TEAM?
Not automatically — but many former CJR participants are among the 741 hospitals on CMS's TEAM roster. CMS used CBSA selection plus IPPS status and considered prior CJR and BPCI Advanced experience when finalizing the participant list. Confirm at /cms-team/participating-hospitals.
How is TEAM different from CJR in practice?
Three big shifts. First, TEAM covers five surgical episodes (CABG, LEJR, major bowel, SHFFT, spinal fusion) instead of CJR's two. Second, TEAM's episode is 30 days post-discharge versus CJR's 90 days, which changes post-acute partnership economics significantly. Third, TEAM offers three risk tracks (including a no-downside Track 1) instead of CJR's single risk profile — giving hospitals a smoother on-ramp.
What lessons did CMS take from CJR into TEAM?
CMS retained CJR's mandatory geographic-selection structure but expanded episode types beyond joint replacement. The agency added the multi-track risk structure to address concerns about hospitals being forced into downside risk before operational capacity caught up. The 30-day window (vs CJR's 90-day) reflects empirical findings that most cost variance occurs within the first month post-discharge.
Will hospitals that succeeded under CJR succeed under TEAM?
Operating muscle from CJR — particularly post-acute care coordination, real-time episode tracking, and discharge protocols — transfers directly to TEAM. But CJR success was concentrated in LEJR. TEAM expands accountability into four additional episode types (CABG, major bowel, SHFFT, spinal fusion) where many CJR-experienced hospitals have less infrastructure. The biggest delta is episode-type breadth, not core methodology.