Helping Navigate the Complexities of Bundled Payments for Care Episodes

Positive results have been seen in pilot bundled payment programs, and studies have reported significant projected savings potential. Although payers and providers are interested in bundled payments for episodes of care, widespread deployment has yet to occur because programs are complex to develop and administer without the right supporting infrastructure. Automated solutions are required to apply episode definitions and bundle claims in real time for accurate payments.

McKesson Episode Management™, a highly configurable, rules-based solution for advanced reimbursement, combines clinical support and claims transaction functions to help:

• Support full-scale bundled payment programs
• Promote quality care
• Reduce administrative and medical costs

McKesson Episode Management leverages the proven performance of McKesson Total Payment™ platform, which leading health plans use to return accurate claims payment decisions for approximately 74 million covered members.

McKesson Episode Management:

• Automates episode definitions for accurate bundled payments, both retrospective and prospective
• Combines authorizations and episode initiation in one step
• Provides expert clinical support for coordinated, evidenced-based care
• Bundles and pays episode claims in real time, within current claim system workflows
• Incorporates the flexibility to use any definition set, including PROMETHEUS

McKesson supports your success at every step with experienced, knowledgeable experts who can analyze potential and actual impacts, enable program set-up and provide strategy validation.