Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Goal of This Study

02/01/2009

The Assistant Secretary for Planning and Evaluation (ASPE) contracted with RAND to explore how episodes of care could be defined for a limited set of clinical events/conditions and, based on varying definitions, to consider ways in which the alignment of performance measurement, accountability, and incentives to providers could be improved within the current Medicare payment and performance measurement systems in the near term.  RAND was also tasked to provide ASPE with options to consider in moving toward broader episode-based performance measurement and payment reforms to encourage high-quality, efficient, and coordinated care.  A core piece of the work involved using two commercially available episode grouping software tools to construct episodes of care, which were then used to identify the issues that would need to be considered in applying episodes as a basis for payment and/or performance measurement.

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