The Power of Episodes
The Power of Episodes
Healthcare services are generally bought and sold on a fee-for-service basis. This has proven to encourage delivery of too many services while leaving patients with no idea what a course of treatment will cost. Bundled payments, or episodes of care, for all the services in a patient episode transform how we shop for and purchase healthcare.
What is an Episode?
Episodes of Care encompass everything related to a medical condition — from diagnosis to recovery — under one bundled payment. This removes the guesswork and surprises, replacing unpredictable bills with guaranteed pricing that covers all aspects of care.
The Compelling Advantages of Episodes of Care
Predictability
Employers and employees know upfront how much their care will cost.
Transparency
Employers can budget effectively, with no hidden costs.
Efficiency
Reduce over-delivery of services and encourage competition among providers.
Proven Cost Savings and Financial Sustainability
Commercial Success
Commercial insurers and health plans are adopting episodes-based payment models for high-cost, predictable conditions such as joint replacements, maternity care, and chronic disease management. Research demonstrates that EoC programs reduce unnecessary services by bundling payments, encouraging efficient care delivery.
10-12%
Orthopedic bundles have been shown to cut costs by 10-12% without sacrificing quality.
Medicare Savings
Programs like the Bundled Payments for Care Improvement (BPCI) Advanced and Comprehensive Care for Joint Replacement (CJR) have reduced overall Medicare expenditures while maintaining quality standards.
$1-3k
BPCI achieved cost reductions ranging from $1,000 to $3,000 per episode across joint replacement bundles, while still maintaining quality standards.