Episodes of Care: Leveraging Payor-Provider Collaborations to Advance Value-Based Healthcare

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The episodes of care (EOC) model is a value-based model that engages specialists in the total cost of care relative to a particular healthcare diagnosis, procedure, or event.

Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ) is uniquely positioned to speak to the EOC model, having awarded $3 million to 51 specialty medical practices as part of a shared savings arrangement through the company's Episodes of Care program.

Pre-publication discount on Episodes of Care: Leveraging Payor-Provider Collaborations to Advance Value-Based HealthcareEpisodes of Care: Leveraging Payor-Provider Collaborations to Advance Value-Based Healthcare examines how Horizon BCBSNJ, a national leader in the advancement of Episodes of Care, developed its EOC model, from pilot status in 2010 to the current scaled program that has improved quality and patient experience while reducing overall costs.

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In this 22-page resource, Lili Brillstein, director of the Horizon EOC program, outlines her organization's EOC initiative and the unique collaborative approach that engaged providers in the program. She provides details on the following:

  • Scaling of its EOC pilot for hip and knee replacements from more than 200 process and outcomes measures to a handful of measures;
  • The transformational effect of its retrospective upside-only model on provider engagement;
  • Selection criteria for episodes and participating providers;
  • The benefits of virtual groups for smaller practices wishing to gain scale;
  • EOC program goals, including key financial, quality and patient satisfaction indicators measured by Horizon BCBNJ;
  • Horizon BCBSNJ's current portfolio of retrospective episodes;
  • Select program results, including comparison of EOC to non-EOC participants;
  • Future plans for Horizon BCBSNJ's EOC initiative;
  • And much more.

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A multi-user license will provide you with the right to install and use this information on your company's computer network for an unlimited number of additional workstations within your organization for a one-time fee. To have this valuable resource on your network, or to inquire about ordering bulk copies in print or Adobe PDF, please e-mail sales@hin.com or call 888-446-3530.

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