On August 28, 2024, the Centers for Medicare & Medicaid Services (CMS) adopted a final rule that created a new mandatory alternative payment model called the Transforming Episode Accountability Model (TEAM). (89 Fed. Reg. 68986, Aug. 28, 2024). The final rule included a voluntary Decarbonization and Resilience Initiative within TEAM to assist hospitals in addressing the threats to the nation’s health and its health care system presented by climate change and the effects of hospital carbon emissions on health outcomes, health care costs and quality of care. The voluntary initiative has two elements: (1) technical assistance for all interested TEAM participants and (2) a voluntary reporting option to capture information related to Scope 1 and Scope 2 emissions as defined by the Greenhouse Gas Protocol framework, with the potential to add Scope 3 in future years. The start date for the initiative is January 1, 2026.