On November 10, CMS posted a request for comment on episode groups, and clinical criteria and patient characteristics to classify patients into care episode and patient condition groups. CMS developed these episode groups pursuant to section 3003 of the Affordable Care Act (ACA) to use in Supplemental Quality Resource Use Reports (QRURs). Section 101(f) of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to establish care episode groups and patient condition groups, and related classification codes, to measure resource use for purposes including the new Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs). To that end CMS seeks stakeholder input on the future role of episode groups in resource use measurement. Comments should be sent to firstname.lastname@example.org by 11:59 pm EST by February 15, 2016.
The episode groups summary document is available here.
The CMS MACRA information page is available here.