ABSTRACT
The Episode Treatment Group™ methodology is a patented case-mix adjustment and episode-building system that uses routinely collected inpatient and ambulatory claims data. The nature of conflict in most organizations is probably overblown and usually stems from one of the essential conflict patterns seen here. In moving toward a performance-based environment, everything eventually connects with another. Many physicians believe that as the performance-based contracting environment becomes saturated with more data and agencies from Agency for Health Quality and Research to state credentialing, databases on health issues and professional licensure are more useful. Studies reported in publications such as Health Affairs, American Hospital Association, and the Managed Care Journal all summarize the critical aspect of payment as a key driver to encourage providers to participate in quality improvement plans. In most settings performance-based contracting is enhanced through electronic transfer of transactional and clinical chart data.
