Episode-based Performance Measurement and Payment

Making It a Reality

Published in: Health Affairs, v. 28, no. 5, Sep. 2009, p. 1406-1417

Posted on RAND.org on August 31, 2009

by Peter S. Hussey, Melony E. Sorbero, Ateev Mehrotra, Harry H. Liu, Cheryl L. Damberg

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Proposals to use episodes of care as a basis for payment and performance measurement are largely conceptual at this stage, with little empirical work or experience in applied settings to guide their design. Based on analyses of Medicare data, the authors identified key issues that will need to be considered related to defining episodes and determining which provider is accountable for an episode. The authors suggest a number of applied studies and demonstrations that would facilitate more rapid movement of episode-based approaches from concept to implementation.

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