The next generation solution for managing episode
Automation makes episode payments effective, scalable and cost-efficient. Edifecs Population Payment Management Episodes for Care Module provides a comprehensive software module to automate the complete episode lifecycle, from design to episode management to audit and reconciliation with external third party payers. The module provides analytics and workflow tools for administering and scaling gainsharing with episode providers. Performance dashboards and management reports provide visibility to episode and gainsharing performance to all collaborating providers in real time.
Edifecs Population Payment Management Episodes of Care Module automates the complete episode management lifecycle, from design to management to audit and reconciliation with external third party payers. It evaluates historical and current performance of providers to identify preferred episode collaborators. IDNs, hospitals, physicians and post-acute care providers can leverage the module to manage alternate episode-based payment models such as Comprehensive Care for Joint Replacement, bundled payments including common cardiac, oncology care etc.
CMS CJR collectively anchors a quarter of all lower extremity joint replacement episodes nationwide. While hospitals bear the ultimate financial responsibility under CJR, to be successful, you must cultivate relationships with other providers, orthopedic surgeons, post-acute, and primary care collaborators to align around critical price targets and quality metrics. The ability to design and administer gainsharing programs with near real-time performance visibility shared across all collaborators is the key to success.Assess Readiness
Population Payment Management Episodes of Care module for CJR combines custom CMS analytics essential for strategic care redesign, preferred provider selection and gainsharing program design. Interactive dashboards, reports and workflow enable episode providers to understand care decision impacts while gaining insight into the current performance of signed contracts.