Introduction to Episodes

The materials on this page are designed to provide you with an introduction to the Episodes of Care program. An episode focuses on the health care delivered in association with an acute health care event and is triggered by specific claims filed by a facility, provider group or individual provider. The episode duration, or episode window, can include the time before the trigger (pre-trigger), during the trigger period and after the trigger (post-trigger). The episode can include services from multiple providers, but the episode is designed to only include spend relevant to the episode.

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This figure depicts a typical Episode of Care.