Report Performance on High-Cost Episodes of Care

Source: Governor’s Office of Health Transformation

In March 2015, Ohio’s largest health insurance plans (Anthem, Aetna, Medical Mutual, United, CareSource, Buckeye, Molina, and Paramount) began measuring and reporting provider performance on high-cost episodes of care using definitions and measures developed jointly with the Governor’s Office of Health Transformation.

A second wave of episodes was designed for implementation in 2016, and a third wave is set for implementation in 2017.

The goal of the episode-based payment model is to reduce the incentive to overuse unnecessary services within each episode and financially reward better health outcomes and cost savings through improvement.

• Episode model overview
• Performance report example
• Detailed information for providers.