On a quest for quality: The episodic care journey
As part of the government’s fundamental efforts to reform the healthcare delivery system, three flavors of programs are emerging to move healthcare from volume-based payments to value-based payments:
1. Episodic Care/Bundled Payment Program
Organizations and providers receive payment for all services a patient receives over the course of a defined clinical episode or period of management. Typically, a hospital receives a single payment which it must allocate and distribute to all “downstream” participants.
2. Managed Care/Global Payment Program
Organizations are held accountable for the total cost of care and receive payments based on their overall achievement of quality and cost goals. Failing to meet these goals often results in payment reductions and/or penalties.
3. Primary Care Transformation
Primary Care practices receive financial incentives based on their ability to meet certain performance and process expectations based on their ability to reduce costs and adopt a “whole patient” model to improve outcomes.
Let’s take a closer look at the episodic care journey. What is it? Why is it important? How can Allscripts help?