Heather Seitz, DPT, Director of Clinical Programs
June 5, 2025

The CMS TEAM model is arriving in January 2026, and it brings a sharp new lens to hospital spending, one that doesn’t end at discharge. For hospitals and physicians, this means every dollar spent within 30 days of an elective lower-extremity joint replacement (LEJR) will count toward a shared cost target, even if the patient is referred out for post-acute care. Whether the patient sees a physical therapist in-home, visits an outpatient clinic, or enrolls in home health services, CMS is watching, and the hospital is financially on the hook.

The takeaway? Smart, evidence-based decisions about post-op rehabilitation are now essential. Here are three ways to reduce costs and financial risk using outpatient at-home physical therapy.

Understand the Cost of Your Physical Therapy Providers: Let’s Talk About Home Health

Home health has long been a go-to discharge option for total joint replacement, especially for Medicare patients. Born from the need to support medically complex, often homebound individuals, it became a standard of care before outpatient-at-home physical therapy was even an option.

But here's the problem: many LEJR patients don't need the level (or the price tag) of home health care.

  • Home health episodes can cost as much as $3000 in the first 30 days post-discharge
  • Kins averages $1,000 in the same time frame, with the same or more visits, with licensed PTs still seeing patients in their homes

The cost difference is rooted in that you pay for several forms of care (RN, OT, and PT) when most patients undergoing LEJR don’t need that level of care. Home health draws from Medicare Part A, a bucket that’s often over-utilized and over-priced, especially for patients who aren’t bed-bound. Kins, by contrast, operates under Medicare Part B, providing outpatient care in the home setting. That means lower costs, appropriate utilization, and greater alignment with CMS’ value-based care goals.

Ensure High-Quality Outcomes Drive Cost Efficiency

Under the TEAM model, savings only count if outcomes hold up. That’s because complications, readmissions, and overutilization don’t just hurt patient recovery—they drive up episode costs and wipe out any potential gains.

Poor physical therapy outcomes can quietly derail an otherwise smooth surgical episode:

  • Low adherence leads to stalled recovery

  • Fragmented care invites miscommunication

  • Delayed rehab increases risk of complications and emergency visits

  • Extra visits don’t always mean better results—they often mean missed opportunities for smarter, more focused care

Kins’ outpatient-at-home model is built to deliver better results with fewer complications:

By sending licensed PTs directly to patients' homes for 1:1 care we increase engagement, reduce the need for excessive visits, and are able to perform a comprehensive home safety assessment to reduce the risk of falls. That combination helps keep care on track and patients out of the ER.

Better outcomes aren’t just a clinical win. They’re a cost-control strategy.

Question the Quality of Care (and Coordination) You’re Getting

Reducing risk under TEAM isn’t just about where physical therapy happens, it’s about how that care is delivered and coordinated.

  • Start fast: Ensure care begins within 24–48 hours post-discharge to maintain mobility and prevent setbacks.
  • Standardize protocols: Use evidence-based, post-op rehab plans tied to functional milestones like gait and range of motion.
  • Improve communication: Direct lines between therapist and surgical team help flag red flags early—surgical wound complications, pain, DVT symptoms—and prevent readmissions.
  • Reduce admin burden: One PT partner = one channel for communication and documentation.
  • Track what matters: Kins tracks and shares dashboards covering functional outcomes, patient satisfaction, and episode cost—aligned to TEAM priorities.

These aren’t future-state ideas. They’re what Kins is delivering today, at scale.

Ready for TEAM? Kins Can Help.

Kins partners with health systems and physician groups to provide Medicare-certified outpatient physical therapy—direct to patients’ homes, backed by robust clinical protocols, measurable outcomes, and easy integration with surgical teams.

Want to see how we could help your organization prepare for TEAM and reduce your risk exposure? Schedule some time or email me here.

References

  1. Merolli, M., Gray, K., Choo, D., Lawford, B. J., & Hinman, R. S. (2022). Use, and acceptability, of digital health technologies in musculoskeletal physical therapy: A survey of physical therapists and patients. Musculoskeletal Care, 20(3), 641–659. https://doi.org/10.1002/msc.1627
  2. Kloek, C. J. J., Janssen, J., & Veenhof, C. (2020). Development of a checklist to assist physiotherapists in determination of patients’ suitability for a blended treatment. Telemedicine and E‐Health, 26(8), 1051–1065. https://doi.org/10.1089/tmj.2019.0143
  3. https://www.ascenti.co.uk/sites/default/files/pdfs/Virtual%20Physiotherapy%20-%20Ascenti%20June%202020.pdf
  4. Sara Keel, Anja Schmid, Fabienne Keller & Veronika Schoeb (2022): Investigating the use of digital health tools in physiotherapy: facilitators and barriers, Physiotherapy Theory and Practice, DOI: 10.1080/09593985.2022.2042439
  5. Cottrell, M., Galea, O., O’Leary, S., Hill, A., Russell, T. (2017). Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis, 31(5), 625-638.

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