When CMS rolls out new compliance mandates, most hospital leaders focus on policy and documentation. But with the TEAM (Transforming Episode Accountability Model) Mandate, there’s a new game-changer in play: data infrastructure. Hospitals that fail to modernize their data pipelines, EHR integrations, and reporting networks risk noncompliance, revenue loss, and audit exposure. TEAM requires real-time visibility, accurate risk capture, and seamless PROM and SDoH reporting—all of which depend on a robust, interoperable IT ecosystem.

In this post, we break down what healthcare leaders need to know to ensure their networks are TEAM-ready.

Why TEAM Demands More Than Clinical Excellence

Under TEAM, outcomes aren’t just tracked—they’re linked to reimbursement. That means:

• PROMs and SDoH data must be digitally captured and transmitted
• Claims must align with HCC crosswalks and bundle-specific logic
• Audits are automated and real-time, not retrospective
• Performance data flows through the TEAM Connect platform

None of this is possible without solid infrastructure. Paper processes, siloed EHRs, and manual workarounds will cripple your ability to comply.

6 Data Capabilities Your Hospital Needs for TEAM

Here’s what CMS-ready data infrastructure looks like:

• 1. Interoperable EHR + PROM Integration

  PROM collection (pre-op + post-episode) embedded into workflows

  Integration with wearable and mobile tools for remote reporting

• 2. Real-Time HCC Crosswalk Engine

  Cross-referencing diagnoses to HCC codes in real time

  Aligns with bundle-specific logic and risk scoring

• 3. Structured SDoH Data Capture

  Standardized intake fields

  Mapping to CMS-specified social determinants

• 4. Automated Claims Review and Risk Scoring

  Real-time validation before claims hit the CMS pipeline

  Flags errors before they trigger audits

• 5. TEAM Performance Dashboards

  Episode-level cost, quality, and attribution insights

  Benchmarks against peers and CMS targets

• 6. Audit-Ready Data Lake

  Timestamped logs of PROM, SDoH, and clinical documentation

  Query-ready for CMS TEAM Connect or RAC audit requests

Common Infrastructure Gaps That Put You at Risk

Many hospitals—especially mid-size and rural systems—face these issues:

• EHRs that don’t support bundle-level logic
• Disconnected PROM tools with no data pipeline
• Manual SDoH capture in unstructured fields
• No real-time audit alert system
• Outdated claims processing rules

The result? Incomplete data, inaccurate risk scoring, and compliance failures under TEAM.

SolvEdge Insight — The Infrastructure Bridge for TEAM

SolvEdge empowers hospital IT and compliance teams with:

• A plug-and-play HCC crosswalk engine that integrates with your EHR

• PROM and SDoH capture modules that meet TEAM formatting and timing requirements

• An API-ready platform to sync real-time data with TEAM Connect

• TEAM compliance dashboards that flag gaps before CMS does

• A data warehouse architecture that consolidates episode-level documentation for audits

With SolvEdge, you can meet TEAM’s data demands without overhauling your entire tech stack.

What C-Suite and IT Leaders Should Be Asking Now

To future-proof your TEAM readiness, ask these key questions:

• Is our EHR integrated with PROM and SDoH workflows?

• Do we have real-time visibility into HCC alignment for TEAM bundles?

• Can we proactively identify claims or documentation at risk of audit?

• How are we transmitting data to TEAM Connect—and how fast?

• What KPIs are we tracking for TEAM bundle performance?

If the answers are unclear, it’s time to prioritize data infrastructure in your compliance roadmap.

Build the Digital Foundation Now

The CMS TEAM Mandate isn’t just a policy shift—it’s a technical leap. Success hinges on your hospital’s ability to manage, transmit, and audit data in real time. Without a strong infrastructure, even the most clinically advanced organizations may struggle.

Invest in data infrastructure now—and avoid scrambling later.