Module 5
Running an Episode Program
Post-acute management is where the savings are and where the harm would be. Plus the cost accounting most hospitals lack, how savings get distributed, and an honest scorecard.
By the end of this module, you will be able to:
- Build the post-acute discipline that produces episode savings, and recognize where it turns harmful
- Specify the episode analytics a hospital needs beyond its own cost accounting
- State what episode payment reliably achieves and what it cannot address
- Managing Post-Acute Care Every documented episode saving came from post-acute care. This is the operational discipline that produces it, and the line where it becomes harmful. About 5 min
- The Internal Economics An episode program that cannot tell you where its margin came from cannot be managed. Cost accounting and distribution are where most programs quietly fail. About 5 min
- Episode Payment: An Honest Scorecard The capstone: episodes work, modestly, on a narrow set of procedures, through one mechanism that runs out. That is a useful tool and not a strategy. About 5 min
Module quiz
Answer all questions to see your score.
1. Why can a hospital not manage an episode program from its own cost accounting?
The target price covers all Part A and B spending in the episode. Managing to it requires claims-based episode analytics joined to clinical data.
2. What typically happens when episode savings are not distributed to the clinicians who produced them?
Distribution is not a reward for past behavior, it is the mechanism that sustains future behavior, which is why episode programs commonly do well in year one and drift afterward.
3. What is the decisive limitation of episode payment?
Only total cost of care accountability asks the volume question, which is why episodes belong inside population accountability rather than instead of it.