NASS 2025 RECAP
Medicare TEAM Symposium: Navigating Bundled Payments for Spine Fusions
Jason Friedrich, MD
Editor in Chief University of Colorado School of Medicine Aurora, CO
The North American Spine Society (NASS) 2025 Annual Meeting featured a high-level symposium on Medicare’s Transforming Episode Accountability Model (TEAM). This mandatory bundled payment initiative, set to launch January 1, 2026, represents a shift in how spine fusion procedures will be reimbursed under traditional Medicare. Both curiosity and skepticism could be felt across the auditorium as the expert panel explored the policy’s design, implications, and strategies for success. This symposium was filled with high-yield information that can serve as an initial roadmap into TEAM. I encourage all interested readers to watch the full symposium via NASS Anytime.
What is TEAM?
Brook Martin, PhD, MPH (University of Utah Health), opened the session by outlining TEAM’s core principles. Bundled payments aim to curb cost variation in fee-for-service models by assigning a single payment for all services within a defined episode of care. Procedures included in TEAM include coronary artery bypass grafts, major bowel procedure, lower extremity joint replacement, surgical hip and femur fracture treatment, and spinal fusion.
For spine fusions, this means covering costs from the anchor surgery through 30 days post-discharge. Hospitals meeting target prices share in savings; those exceeding targets face repayment obligations. TEAM will run for five years, with downside risk commencing in 2027.