Opportunities and Challenges for Episode-Based Payment.
N Engl J Med. 2011 Aug 24;
Authors: Mechanic RE
Episode-based payment - in which reimbursement for medical services delivered during defined episodes of care is bundled together - is one of several payment reforms contained in the Affordable Care Act (ACA). Episodes cover a specified period that ranges from a few days to a year, during which patients may receive care from multiple providers. Medicare's diagnosis-related-group (DRG) system is a form of episode-based payment in which all inpatient hospital care associated with an admission for a designated diagnosis is bundled together. But the ACA's episode-based payment goes far beyond DRGs, defining episodes over a broader time horizon and more . . .
PMID: 21864162 [PubMed - as supplied by publisher]