Devising Episode-of-Care Performance Measures for Select Illnesses

Researchers at the RAND Corporation developed detailed episode-of-care frameworks and analyzed performance measures for selected medical conditions for use in value-based purchasing.

Dates of Project: November 2010 to May 2012

Description: Researchers at the RAND Corporation developed diagrams that illustrate possible patient trajectories and associated performance measures for the following conditions: pregnancy, type 2 diabetes, hip or knee replacements, coronary angioplasty, depression, and ischemic stroke.

Key Recommendation

To evaluate doctors and hospitals based on episodes of care, the health care industry should fill existing gaps in performance measures such as those that evaluate:

  • Changes in health status of a patient over time

  • The patient’s experience—such as level of pain—over the course of an episode

  • Prevention of additional episodes of care

  • Bundled care processes associated with a particular outcome

"If you bundle a set of services collectively, medical practitioners will start structuring their system to be able to work together. It is really trying to get everyone working on the same page," said Project Director, Cheryl Damberg.

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RAND developed performance measures for episodes of care for 6 conditions incl. type 2 diabetes