What You Should Know
- The Raise: Rainfall Health, an AI-driven compliance platform, has closed a $15M Series A funding round led by Two Bear Capital, along with support from other notable investors.
- The Catalyst: The investment coincides with the launch of the CMS Transforming Episode Accountability Model (TEAM) on January 1, 2026. This mandate incentivizes hospitals to improve outcomes for five high-spend surgical procedures.
- The Opportunity: While compliance is often seen as a cost, Rainfall argues it is a revenue driver. By meeting TEAM quality metrics, hospitals can increase revenue by 20%, potentially yielding over $100M in new revenue per health system.
The Five Surgeries That Matter
On January 1, 2026, a new set of rules quietly went into effect for American hospitals. Known as the Transforming Episode Accountability Model (TEAM), this CMS mandate fundamentally changes how hospitals are paid for five high-cost surgeries.
The TEAM model focuses on outcome accountability for five specific, high-volume procedures:
- Lower extremity joint replacement
- Spinal fusion
- Coronary artery bypass graft (CABG)
- Major bowel procedures
- Hip/femur fracture treatment
Under the new rules, hospitals that meet specific quality metrics—such as consistent patient follow-ups and clear recovery instructions—can see a 20% increase in revenue for these service lines. For a large health system, that bump can exceed $100M.
Compliance as a Product
Rainfall’s platform acts as a “digital blueprint” for this new environment. Instead of relying on manual checklists or disjointed spreadsheets, the AI standardizes the collection and reporting of patient outcomes.
- Standardization: It ensures that every patient interaction, from discharge to recovery, is tracked and reported in a way that satisfies CMS requirements.
- Workflow: It automates the complex regulatory requirements, freeing up clinicians to focus on care rather than data entry.
The “RAIN Compliant” Standard
The company is also pushing to establish a national standard through its RAIN Compliant™ designation—a framework adopted by hospitals and payers to verify that a system is meeting the new rigorous demands of value-based care.
“Hospitals have a tremendous opportunity to increase their revenues by delivering high-quality post-acute care that includes consistent check-ins, clear patient instructions, and clinician follow-ups,” said Eddie Qureshi, CEO and Founder of Rainfall Health. “By building out our AI and implementation teams, we will ensure our partners take advantage of this opportunity with CMS while delivering a consistent patient experience. This funding is a vital step for Rainfall as we continue to build the country’s first recognized standard for outcome-based care.”
