Clinical episode analytics provide essential tools for analyzing new healthcare models by defining episodes of care, differentiating between related and unrelated services, attributing patients to accountable providers, quantifying variations in utilization, cost, efficiency and quality, and measuring adherence to protocols. These analytics allow healthcare organizations to holistically view patient care by linking episodes and analyze variations to collaborate with payers and improve outcomes.

1. Episode Analytics: Essential Tools
for New Healthcare Models

3. Key Findings
• Clinical Episodes = Right unit of analysis
• Episode Analytics have advanced
• Episode Analytics in use now

5. Advances in Episode Analytics
• Define (& modify) episode
• Differentiate between typical, complication and unrelated services
• Attribute patients to accountable providers
• Quantify variation in utilization, cost, efficiency, quality
• Measure adherence to protocols
• Calculate actual vs. risk adjusted cost
• View holistic patient care by linking episodes

6. Episode Analytics Today

7. Action Points
• Analyze variations in episodes of care
• Start with claims data
• Go beyond traditional episode groupers
• Attribute patients to correct managing physician
• Measure adherence to evidence-based practice guidelines
• Use the data to collaborate with payers

8. Peter Chingos
Sr. Solutions Architect
Health Analytics Practice,
Health & Life Sciences
SAS North America
peter.chingos@sas.com
(919) 531-9685