An episode of Home Care near Lomita CA includes all the services provided to a patient to treat a clinical condition or procedure. Providers responsible for episodes of chronic diseases would assume responsibility for treating patients on an outpatient basis and avoiding hospitalization to the extent possible. The recommendations contained here serve as a starting point for a stronger agenda for evaluating the applications of Home Care near Lomita CA episodes. For these reasons, episodic approaches to chronic disease care should be evaluated in conjunction with patient-based approaches. In that sense, an episode will include all clinic-related services provided for a discrete condition or in conjunction with the performance of a procedure and the prices paid for them.
A series of recent health system reform proposals have called for the use of care episodes as a basis for payment and performance measurement. Services are considered to be relevant to an episode if they can be used in the care provided during that episode and are provided during the period in which that episode occurs, regardless of whether such services are considered clinically appropriate or not. The CV ranged from 72 for episodes related to a hip fracture, indicating lower variability, and 269 for diabetes-related episodes, indicating great variability between episodes of the same type of condition. Specific applications of the episodes being discussed include profiling providers to provide comparative feedback to improve quality, public information, pay-per-performance, and “combined payments” for service groups.
Prometheus Payment has performed this type of analysis to analyze several conditions of a national business population and has found that 40% of the costs of the episodes, on average, were for services classified as “potentially avoidable complications”. For people with a mental health diagnosis, an outpatient care episode with an out-of-network provider will not exceed two (years) from the date of enrollment. The most recent proposals, which emphasize creating shared responsibilities for quality and cost among the broadest set of providers involved in patient care, call for the creation of responsible care organizations (ACO) 19 or responsible care systems (ACS), 20: groups of providers who would assume responsibility because of episodes or patients. An episode grouper is software that operates algorithms that determine when an episode should be opened and closed; identifies the health services that should be assigned to one or more different health care episodes; and determines what other episodes a particular episode can be associated with.
