Software

Episode Manager

A value based payment solution for payers that want to integrate prospective payment models into their existing claims workflows.

 

Get Support
Contact Sales

ScaleYour Prospective Bundled Payment Program

  • Streamline program administration by identifying episodes from a trigger claim within your existing claims system workflow and bundle all episode claims in near real-time.

  • Configure your own episode definitions or leverage Prometheus or CMS episode definitions.
  • Integrate fee-for-service pricing by using both Episode Manager and ClaimsXten on the same technical platform, allowing for an efficient mixed model payment approach.

  • Develop and manage bundled payment programs that help define your episodes or reevaluate your existing strategy.

Streamline Prospective Payment Processes

  • Automate prospective bundled payment processes

    • Configure our rules-based solution that works within your current claim workflow to bring automation to prospective bundled payment programs.
    • Combine clinical dashboards and claims transaction functions to help support prospective payment programs at scale, promote quality care, and help reduce administrative and medical costs.
    • Simplify the transition from retrospective to prospective payment models approach when you are ready.

  • Configurable episode of care definitions

    • Support for multiple episode configurations and custom episode definitions.
    • Leverage Prometheus or CMS episode definitions or customize these definitions to meet your specific market needs.

  • Episode based payments monitoring

    • Allow episode analysts to compare program definitions to actual claim data and to recognize trends with summary and detail reports.
    • Get a clear and consistent view of key performance metrics associated with episodes from visual dashboards.
    • Help Adjudicate claims quickly and accurately to all the providers included in the episode of care.

Our outcomes

View all insights

On-demand Webinar

The Evolution of Value-Based Care

On-demand Webinar

The Evolution of Value-Based Care

Learn how to use retrospective analysis to define equitable, empirically grounded Episodes of Care that you can successfully apply in a prospective context.

Learn More

Podcast

Value-Based Care Innovation to Drive Outcomes

Podcast

Value-Based Care Innovation to Drive Outcomes

Learn how Prometheus Analytics® deliver data-driven insights payers and providers need to excel at value-based care—enabling fee-for-value and bundled payments.

Learn More

On-demand Webinar

New Innovations in Value-Based Care Webinar

On-demand Webinar

New Innovations in Value-Based Care Webinar

Discover how new technology and collaboration are creating powerful VBC models.

Learn More

PRODUCT SUPPORT

Need support for
this solution?

Get support
Explore related solutions

Join Community discussions

Find and share knowledge, exchange ideas, and collaborate with peers and Change Healthcare experts to drive your solutions to success.

Let’s start a conversation

We’re here to help you find out how this solution could benefit your organisation. Complete the quick form to the right, and someone will reach out to you soon.

Our experts will:

  • Discuss your individual use case and business needs
  • Explain our features, benefits, and services
  • Show how this solution can help achieve your goals

Want more information? Start here.

Thank You

We appreciate your interest in Change Healthcare. A member of our team will contact you to better understand your needs and discuss potential solutions.

Together, we are accelerating the journey toward improved lives and healthier communities.