Exploring Episode-Based Approaches for Medicare Performance Measurement, Accountability and Payment Final Report. Summary: Episode Construction


A broad variety of episode definitions have been used or proposed. The greatest amount of activity has focused on developing episodes related to a hospitalization. This type of episode has been discussed mainly in terms of payment applications, although recent examples, such as Geisinger's CABG episode, explicitly include the quality of the care provided during the episode. Proprietary episode groupers are commonly used to define broad episodes of care used for resource use measurement. Other types of episodes definitions, such as outpatient procedure episodes or chronic condition episodes, have been used in limited applications of payment and/or performance measurement applications.

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