All information that could be relevant turned out to be more than just the data constituting an episode of care
The real national excitement is in our ability to provide a price to the payer for the entire episode of care
," said Jeff Moser, Vice President at Sg2.
This method lays an empirical foundation for identifying an episode of care
for medical conditions that can serve to complement the existing methods of trial design.
Even though the PAP directly controls only a portion of the spending for the episode of care
, he or she is responsible for the global cost of that episode.
The episode of care
was conceived as the essential conduit through which the natural history of any given patient's care could be comprehended.
It requires real commitment to take that first step because this program is a fundamental rethinking of the entire episode of care
This patent-pending solution automates the processing of episode-of-care payments, including the unique feature of a single prospective payment to a group of clinicians and hospitals for all the medical services during an episode of care
Furthermore the general practitioners performed fewer investigative studies, referred patients less often, and saved an average of [pounds]60 per episode of care
when compared to the emergency department staff.
One such example is a bundled reimbursement to a group of providers for a member's hip replacement, an episode of care
that would include an inpatient stay, rehabilitation, primary care, emergency room services and other care related to the procedure.
It is the umbrella organization for the Bridges to Excellence program and PROMETHEUS Payment model, as well as the creator of episode of care
, or Evidence-informed Case Rate (ECR), definitions and the ECR Analytics system.
These systems allow physicians and other clinicians to easily assess the patient's progress and course of treatment across an entire episode of care
Aligning Payment for All Services Related to an Episode of Care
Helps Payers and Providers Collaborate on Delivering Value, Not Driving Volume