Frequently Asked Questions
What are Episodes of Care?
An Episode of Care is defined as the set of services provided to treat a clinical condition or procedure. It is bounded in time – for example, a year of treatment for a cardiac condition or 90 days for a major surgical procedure – and creates accountability for the management of the person’s condition or health event.
Why are Episodes of Care a top priority for the National Alliance and Coalitions?
The National Alliance and its member coalitions believe that as an alternative payment model, Episodes of Care hold the potential to greatly improve the value of care by holding providers accountable for episode-specific quality and costs. This means that through Episodes of Care employers have an opportunity to realize cost savings while significantly improving the quality of care their employees receive.
What is the overall objective for the Episode of Care initiative of the National Alliance, Member Coalitions, and their employer members?
The National Alliance and member coalitions partnership is intended to drive better outcomes through a reformation of the delivery system – powered by stronger incentives encapsulated in an Episode of Care program that empowers front line clinicians with the information they need to continuously improve quality and reduce costs.
What is the process for meeting the Episode of Care Initiative objective?
The National Alliance intends to meet its objectives for the episode of care initiative through a coordinated effort from multiple players, across markets. Specifically, the National Alliance will work with its Coalitions to empower employers to develop the national standards for building a successful episode of care program across the nation. The standards will be met by building collaboration with carriers and providers to understand their current capabilities. If needed, Remedy will bridge program-related gaps existing carriers may have in order to create a program that meets the Alliance/Coalition’s standards on a national scale. Remedy will provide the resources needed in order for providers to successfully participate.