Care Coordination Episode Profiler

Examine national-level, post-hospitalization episodic spending

Tool Basics

Suggested Users

• Hospital executives
• Planners
• Analysts
• Finance leaders

Inputs

None

Outputs

National-level episodic spending post anchor hospitalization by site of service




The Comprehensive Care for Joint Replacement (CJR), finalized in November 2015, marked CMS’s first foray into mandatory bundled payments in select markets across the nation. This landmark effort was followed in July 2016 by the (now cancelled) Episodic Payment Measures (or EPM) that expanded mandatory bundles to include conditions such as AMI, AMI with PCI, CABG and surgical hip fixation. Recently, CMS has announced a new voluntary bundled payment initiative, the Bundled Payment Care Initiative (BPCI) Advanced. This effort expands CMS’s prior efforts in BPCI, focusing on a set of 29 conditions within 90-day episodes of care.

The Care Coordination Episode Profiler allows you to view national average episodic spending allocation by site of service for a variety of different bundles as defined in these programs. Users may view post-acute spending across various time intervals following anchor discharge, and modify episodic views from 5 to 90 days following anchor hospitalization.

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