• Video
  • Course
  • JIT

1 hour

All audiences

Refining your clinical focus: inclusions, exclusions and selecting episode length

Refining your clinical focus: inclusions, exclusions and selecting episode length

Learning objectives

After completing this module you should be able to:

  • Define an anchor diagnosis related group (DRG)
  • Describe the rationale for including or excluding clinical conditions in the bundle
  • Assess the interdependence between the selection of DRGs and episode exclusions
  • Describe the factors involved in determining the optimal length of a bundled episode.

Course description

Understanding the principles in designing bundles for bundled payment programs is key to defining the scope of intervention in any project to improve quality of care, efficiency of delivery, and control of costs. This module explains these concepts with text, animated graphs, and case studies. Single best answer questions test knowledge and aid learning.

Needs assessment

The content of this educational activity was determined by assessment of educational need to identify opportunities and gaps in knowledge, skills, and performance. This includes a literature review, review and analysis of national data, and feedback from the organizations that are implementing a bundled payment system. We researched the clinical, operational, leadership, IT, and finance gaps. This includes issues such as: engaging providers beyond the hospital in care redesign, sharing data across care sites, and the importance of consistent implementation of standard care processes. This course is designed for health care professionals, from senior leaders to frontline staff. Through interactive online learning modules, participants will progress from the basics of bundled payments to design, execution, and implementation strategies.

Disclosure statement

It is the policy of the University of California, San Diego School of Medicine to ensure balance, independence, objectivity and scientific rigor. All persons involved in the selection, development and presentation of content are required to disclose any real or apparent conflicts of interest. All conflicts of interest will be resolved prior to an educational activity being delivered to learners through one of the following mechanisms 1) altering the financial relationship with the commercial interest, 2) altering the individual’s control over CME content about the products or services of the commercial interest, and/or 3) validating the activity content through independent peer review. All persons are also required to disclose any discussions of off label/unapproved uses of drugs or devices. Persons who refuse or fail to disclose are disqualified from participating in the CME activity.

Cultural and linguistic competency statement

This activity is in compliance with California Assembly Bill 1195 which requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. Cultural competency is defined as a set of integrated attitudes, knowledge, and skills that enables health care professionals or organizations to care effectively for patients from diverse cultures, groups, and communities. Linguistic competency is defined as the ability of a physician or surgeon to provide patients who do not speak English or who have limited ability to speak English, direct communication in the patient’s primary language. Cultural and linguistic competency was incorporated into the planning of this activity. Additional resources on cultural and linguistic competency and information about AB1195 can be found on the UCSD CME website at http://cme.ucsd.edu.

Contributors:

 Anna Ellis, Carolyn Simpkins

Activity Directors:

 Coleen Kivlahan, Jane Eilbacher

Last updated

01 Jul 2013

Release date

01 Jul 2013

Accreditation

Accreditor credit Accreditation statement
BMJ Learning 1 credit, 1:00 hour BMJ Learning has assigned one hour of credit to this module
Pakistan Society of Family Physicians 1 credit, 1:00 hour The Pakistan Society of Family Physicians has assigned 1 hour of credit to this module.
UAE Ministry of Health and Prevention 1 credit, 1:00 hour This Program has been awarded 1 CPD Credit Hour by the UAE Ministry of Health and Prevention.
UC San Diego School of Medicine 1 credit This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of California, San Diego School of Medicine and BMJ Learning. The University of California, San Diego School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The University of California, San Diego School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

University of Health Sciences Lahore 1 credit, 1:00 hour University of Health Sciences Lahore has assigned 1 hour of credit to this module.