The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.
A practical guide to episode groupers for cost-of-illness analysis in health services research.
Open accessAbstract
Despite the prominence of episode groupers for analysis and reimbursement in US payer settings, peer-reviewed articles using episode groupers for cost-of-illness analysis that informs public health research and decision-making are uncommon. This article provides a brief practical guide to episode-based cost analysis and offers some examples of episode grouper products. It is intended for an audience of health services researchers and managers in public health settings who perform or commission cost-of-illness studies with the US healthcare claims fee-for-service data but lack familiarity with episode groupers.
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Citations
Cites
Two-Year Evaluation of Mandatory Bundled Payments for Joint Replacement
Barnett, M. L., Wilcock, A. D., McWilliams, J. M., Epstein, A. M., Maddox, K. E. J., Orav, E. J., Grabowski, D. C., & Mehrotra, A. (2019) · New England Journal of Medicine · doi:10.1056/nejmsa1809010 · Cited by 295
Evaluation of Medicare’s Bundled Payments Initiative for Medical Conditions
Maddox, K. E. J., Orav, E. J., Zheng, J., & Epstein, A. M. (2018) · New England Journal of Medicine · doi:10.1056/nejmsa1801569 · Cited by 162
Rosen, A. B. (2010) · Cited by 33
Dunn, A. C., Shapiro, A. H., & Liebman, E. B. (2013) · Journal of Health Economics · doi:10.1016/j.jhealeco.2013.09.006 · Cited by 30
Self-citationEpisode-Based Payment: Evaluating the Impact on Chronic Conditions
O'Byrne, T. J., Shah, N., Wood, D. L., et al. (2013) · Medicare & Medicaid Research Review · doi:10.5600/mmrr.003.03.a07 · Cited by 22
The Next Generation of Episode-Based Payments
Navathe, A. S., Song, Z., & Emanuel, E. (2017) · JAMA · doi:10.1001/jama.2017.5902 · Cited by 18
Physicians' Opinions About Reforming Reimbursement
Federman, A. D., Woodward, M., & Keyhani, S. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.369 · Cited by 14
Developing a Prospective Payment System Based on Episodes of Care
Averill, R. F., Goldfield, N., Hughes, J. S., et al. (2009) · Journal of Ambulatory Care Management · doi:10.1097/jac.0b013e3181ac9d6f · Cited by 13
Arkansas Payment Improvement Initiative: Expanding Episodes To Other Clinical Areas
(2015) · Forefront Group · doi:10.1377/forefront.20150519.047837 · Cited by 1
Flagged first, then by citations
Research works printed but not linked: 8
- McKesson Health Solutions, 2017, White paper: journey to value
- Dunn A, 2014, Surv Curr Bus, 95, 1
- National Quality Forum, 2014, Evaluating episode groupers: a report from the National Quality Forum
- MaCurdy T, 2008, Evaluating the functionality of the symmetry ETG and Medstat MEG software in forming episodes of care
- OptumInsight, 2017, White paper: symmetry episode treatment groups
- OptumInsight, 2017, White paper: symmetry procedure episode groups
- IBM Watson Health, 2018, White paper: The medical episode grouper: applications and methodology
- Winkleman R, 2007, A comparative analysis of claims-based tools for health risk assessment
Cited by
Sorted by citations
Assessment of Annual Cost of Substance Use Disorder in US Hospitals
Peterson, C., Li, M., Xu, L., Mikosz, C. A., & Luo, F. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.0242 · Cited by 200
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Metadata
- Authors
- Peterson, C., Grosse, S. D., & Dunn, A.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Bureau of Economic Analysis (US)
- Corresponding author
- Peterson, Cora
- Venue
- SAGE Open Medicine
- Publisher
- SAGE Publications
- Published
- 2019-01
- Volume
- 7
- Pages
- 2050312119840200-2050312119840200
- ISSN
- 2050-3121 (ISSN-L)
- PMC
- PMC6444409
- OpenAlex
- W2933349164
- Cited by
- 26
- References
- 9
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 8 · 2022: 7 · 2021: 2 · 2020: 2
- FWCI
- 3.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- SAGE Open Medicine (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- health insurance claims data, fee-for-service reimbursement, public health decision-making, health services research
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