Episodic Care Services – How to Develop

Slides:

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What are Episodic Care Services?
Who develops the agreement with the company?
How do you establish the cost?
What is the best billing strategy?
What clients are the best targets for this service?

Video:

In today’s rapidly changing healthcare landscape, there is a growing focus on providing episodic care services. What exactly is episodic care, and how can healthcare organizations develop and implement these services? In this blog post, we will explore the concept of episodic care and provide a comprehensive guide on how to develop it within your organization.

Understanding Episodic Care:

Episodic care refers to a single encounter with a patient that focuses on presenting concerns, identified medical conditions, or referred consultation, without the expectation of an ongoing care relationship. It is a model that enables healthcare providers to address acute, non-chronic conditions efficiently and effectively.

Developing Episodic Care Services:

Assessing Market Needs:

Before developing episodic care services, it is essential to assess the market needs in your area. Understand the healthcare landscape and the availability of primary care providers. Identify the gaps in care and the demand for episodic services. This analysis will help you tailor your services to meet the specific needs of your target audience.

Establishing Partnerships:

Creating successful episodic care services often involves collaborations with employers or organizations. Work towards developing agreements that outline the services you will provide, the payment structure, and regulatory compliance. Additionally, define the ongoing monitoring process to ensure the clinic’s effectiveness and optimize outcomes.

Determining Billing Strategies:

When it comes to billing, various models can be implemented based on the services provided and the preferences of the healthcare organization and the client. One common approach is the per member per month fee structure. Alternatively, an hourly rate, coupled with additional fees for specific services, can be employed. It is important to establish clear communication with clients regarding fee structures, as well as review the arrangement periodically to ensure fairness and transparency.

Staffing and Training:

In developing episodic care services, having the right healthcare professionals on board is crucial. Nurse practitioners, physician assistants, and other providers with a background in family practice can play a significant role in delivering high-quality episodic care. Additionally, investing in training programs is essential to ensure staff is equipped to handle the unique challenges and requirements of episodic care.

Building Ongoing Relationships:

Although episodic care is not intended to establish long-term care relationships, it is important to develop pathways for continuing care when necessary. Create partnerships with primary care providers to streamline referrals and ensure patients receive appropriate follow-up care. This collaboration benefits both the patient and the employer, leading to better health outcomes and reduced healthcare costs.

Episodic care services provide a valuable solution for addressing acute, non-chronic conditions efficiently and cost-effectively. By understanding market needs, establishing partnerships, implementing appropriate billing strategies, and investing in staff training, healthcare organizations can successfully develop and implement episodic care programs. Embracing this model not only benefits patients by providing convenient and accessible care but also delivers cost savings and improved efficiency for employers.

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