Four key reasons why episodes of care will work this time

Originally published in Becker's Infection Control and Clinical Quality. May 31, 2016

The concept of defining specific episodes of care for the purposes of measuring quality and efficiency of care has been around for a long time. EOCs define the scope of care and qualification for specific treatable conditions, which is challenging considering the potential complexities of each procedure and condition. EOCs are essential to enabling effective value-based payment models and effective population health programs, but the industry has struggled for years to make standard EOCs part of healthcare.

The seminal work in EOCs was done by Jerry Solon and his colleagues in the 1960s, outlined in an article titled Delineating Episodes of Medical Care. Since then, numerous attempts have been made to implement EOC. For example, in 1996 I led a team at Oxford Specialty Management, a subsidiary of Oxford Health Plans, in the development of an Episodes Engine, a set of systems, procedures and contracting methods to track clinical conditions and the EOC, their costs and outcomes. Finally, the regulatory, technical and cultural forces seem to be aligning to make implementation of EOC a reality.

Today, providers and payers alike are evolving the way they deliver and track care...

Please read the full article in Becker's.