CMS Evaluates Episode-Based Payment Models

The Centers for Medicare and Medicaid Services’ (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) released a report in which seven episode-based payment models were evaluated to identify common themes and best practices from each of the included models.

The episode-based models that were identified as most successful were those in which beneficiaries were most easily identifiable and participating providers and suppliers perceived they were able to impact clinical events.

While the impact of the episode-based models on the quality of care were positive, when performance payments were included in the net costs, Medicare did not save any money. The agency attributes this to the variability in markets and the need to prospectively set target payment amounts.

Additional information about episode-based payment models can be found on the Innovation Center website.



For more information visit the McDermottPlus Payment Innovation Resource Center or contact Mara McDermott at 202-204-1462 or