TY - JOUR
T1 - Episodes of care
T2 - Is emergency medicine ready?
AU - Wiler, Jennifer L.
AU - Beck, Dennis
AU - Asplin, Brent R.
AU - Granovsky, Michael
AU - Moorhead, John
AU - Pilgrim, Randy
AU - Schuur, Jeremiah D.
PY - 2012/5
Y1 - 2012/5
N2 - Optimizing resource use, eliminating waste, aligning provider incentives, reducing overall costs, and coordinating the delivery of quality care while improving outcomes have been major themes of health care reform initiatives. Recent legislation contains several provisions designed to move away from the current fee-for-service payment mechanism toward a model that reimburses providers for caring for a population of patients over time while shifting more financial risk to providers. In this article, we review current approaches to episode of care development and reimbursement. We describe the challenges of incorporating emergency medicine into the episode of care approach and the uncertain influence this delivery model will have on emergency medicine care, including quality outcomes. We discuss the limitations of the episode of care payment model for emergency services and advocate retention of the current fee-for-service payment model, as well as identify research gaps that, if addressed, could be used to inform future policy decisions of emergency medicine health policy leaders. We then describe a meaningful role for emergency medicine in an episode of care setting.
AB - Optimizing resource use, eliminating waste, aligning provider incentives, reducing overall costs, and coordinating the delivery of quality care while improving outcomes have been major themes of health care reform initiatives. Recent legislation contains several provisions designed to move away from the current fee-for-service payment mechanism toward a model that reimburses providers for caring for a population of patients over time while shifting more financial risk to providers. In this article, we review current approaches to episode of care development and reimbursement. We describe the challenges of incorporating emergency medicine into the episode of care approach and the uncertain influence this delivery model will have on emergency medicine care, including quality outcomes. We discuss the limitations of the episode of care payment model for emergency services and advocate retention of the current fee-for-service payment model, as well as identify research gaps that, if addressed, could be used to inform future policy decisions of emergency medicine health policy leaders. We then describe a meaningful role for emergency medicine in an episode of care setting.
UR - http://www.scopus.com/inward/record.url?scp=84860217168&partnerID=8YFLogxK
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U2 - 10.1016/j.annemergmed.2011.08.020
DO - 10.1016/j.annemergmed.2011.08.020
M3 - Article
C2 - 21963317
AN - SCOPUS:84860217168
SN - 0196-0644
VL - 59
SP - 351
EP - 357
JO - Annals of emergency medicine
JF - Annals of emergency medicine
IS - 5
ER -