Episodes of Care Initiative

Overview

As a key value-based care strategy, episodes of care is an alternative payment model that offers incentives to providers to increase coordination and efficiency of care while improving quality and outcomes at lower costs. The National Alliance is collaborating with key stakeholders to help accelerate development of employer adoption of episodes of care across the country.

Our Next Steps

National Alliance member coalitions will continue to assist purchasers in the development, implementation and administration of episodes of care programs with multiple employers active in Florida through the Florida Alliance for Healthcare Value. Other states such as Colorado, Pennsylvania, Tennessee and Texas are also moving forward. To support these efforts, a toolkit is being developed that will provide materials to support the implementation process and educate on standards and carrier assessments.

For more information, please contact Karlene Lucas from the National Alliance of Healthcare Purchaser Coalitions.

Featured Resources

Getting Down and Dirty on Episodes of Care

This panel was held during the 2019 Annual Forum in Washington, DC.

Targeted Commercial Episodes of Care

Commercial Bundle Categories

Frequently Asked Questions

This document addresses frequently asked questions around Episodes of Care.

Featured Coalition in Action

The Florida Alliance for Healthcare Value has been the catalyst for implementation of episodes of care (EOC) bundled payments in Florida. We advocate for the usage of uniform clinical definitions and encourage the use of quality metrics to measure outcomes. We promote the use of standardized and consistent clinical definitions coupled with quality benchmarks to achieve better outcomes. We work with employers, providers, health plans, and conveners to integrate EOC bundles into health benefit design. Learn more.

Episodes of Care (EoC) is HBCH’s primary value-based purchasing initiative. EoC will improve outcomes and lower costs for common orthopedic, cardiovascular, gastrointestinal, and maternity episodes through quality improvement. EoC is also aligned and will be incorporated into HBCH’s other key VBP initiatives — advanced primary care, accountable care organizations, and The Path Forward for Mental Health and Substance Use. We have hosted many stakeholder meetings over the past year. We are in the process of conducting employer opportunity analyses. Implementation is expected in 2021. Learn more.

Our Value Agenda:

Common episodes definitions to align and focus care management and improvement efforts
Quality & appropriateness of care to ensure and promote the right care at the right place for the right patient
Double-sided risk alignment to incentivize a shared commitment to success and patient centered value
Warrantied performance to provide accountability for high performance and outcomes
Relevance for purchasers, patients & providers to enable substantive and sustainable benefits for all stakeholders

“Employer-led episodes of care can truly bring about the change required in the broken healthcare market. Working through our regional and national network of member coalitions can enable faster and more seamless execution of episode-of-care payment models across the country."

Michael Thompson, President & CEO, National Alliance