An episode of care includes all the services provided to a patient to treat a clinical condition or procedure. A quality episode begins with the start of care (SOC) or the resumption of care (ROC) and ends with an evaluation of transfer (TRF), death in the home (DAH), or discharge (DC). This is because the economic incentives offered for care episodes are based on improving patient outcomes. These two main benefits of episodes of care programs, quality of care and cost reduction, are interrelated.
An episode of care plays a key role in pay-per-episode or bundled programs as the healthcare sector adopts value-based care reimbursement models. Quality episodes are used both in process measures (the effectiveness with which home health care agencies use specific evidence-based care processes) and in outcome measures (the outcomes of healthcare experienced by patients). Care episodes combine all the services that are provided within a specific time frame for a single health condition or medical event, rather than using a pay-per-service model. Quality episodes are “designed for each patient” by comparing evaluations from the beginning of care (SOC or ROC) with those at the end of care (TRF), DAH, DC) .In the case of quality measures based on data collected from the OASIS Home Health Quality Reporting Program (HHQRP), a quality episode is a component of developing a measure of quality of home health.
A care episode comprises one or a series of contacts with diagnostic or therapy personnel in connection with a care plan derived from an evaluation or examination...
