In December 2014, the Governor’s Office of Health Transformation (OHT) was awarded a federal grant to implement payment models that support comprehensive primary care and episode-based payments. To date, the OHT, in collaboration with the Ohio Department of Medicaid (ODM), has designed and launched reporting on 31 episodes. The OHT and the ODM value provider input in improving episode design as clinical feedback is critical for the long-term success of the episodes of care program. There will be provider comment sessions in November for clinicians who want to provide feedback on new episodes recently launched.
The provider comment session for three pediatric episodes [otitis media, tonsillectomy, and pediatric acute lower respiratory infection (LRI)] – will be held on Monday, November 6, from 3:30-5:30 p.m. at the ODM located at 50 W. Town Street in Columbus, OH.
The goal of this session is to explore opportunities to improve patient care and to reduce unnecessary variation in clinical practice; ensure episodes of care function in a fair manner, i.e. holds providers accountable for their behaviors, and not for patient behaviors or other factors outside of their control; ensures thorough and accurate process, e.g. appropriate diagnosis; and procedure codes are included.
Family physicians interested in attending are asked to R.S.V.P. to Beanca Cooper.
- Review the core concepts behind Episodes of Care
- Review the Concept Paper for the Episodes: Otitis Media, Tonsillectomy, Pediatric Acute LRI
- Review your episode reports in detail– these can be accessed through the Medicaid MITS provider portal.
- Finally, there is a great deal of general information on the ODM Episode Based Payment web page.