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Episodes of care: is emergency medicine ready?
Ann Emerg Med. 2012 May; 59(5):351-7.AE

Abstract

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.

Authors+Show Affiliations

Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, USA. jennifer.wiler@ucdenver.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21963317

Citation

Wiler, Jennifer L., et al. "Episodes of Care: Is Emergency Medicine Ready?" Annals of Emergency Medicine, vol. 59, no. 5, 2012, pp. 351-7.
Wiler JL, Beck D, Asplin BR, et al. Episodes of care: is emergency medicine ready? Ann Emerg Med. 2012;59(5):351-7.
Wiler, J. L., Beck, D., Asplin, B. R., Granovsky, M., Moorhead, J., Pilgrim, R., & Schuur, J. D. (2012). Episodes of care: is emergency medicine ready? Annals of Emergency Medicine, 59(5), 351-7. https://doi.org/10.1016/j.annemergmed.2011.08.020
Wiler JL, et al. Episodes of Care: Is Emergency Medicine Ready. Ann Emerg Med. 2012;59(5):351-7. PubMed PMID: 21963317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Episodes of care: 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, Y1 - 2011/09/29/ PY - 2011/05/10/received PY - 2011/08/26/revised PY - 2011/08/30/accepted PY - 2011/10/4/entrez PY - 2011/10/4/pubmed PY - 2012/6/23/medline SP - 351 EP - 7 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 59 IS - 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. SN - 1097-6760 UR - https://www.unboundmedicine.com/medline/citation/21963317/Episodes_of_care:_is_emergency_medicine_ready L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0644(11)01544-7 DB - PRIME DP - Unbound Medicine ER -