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Evaluating Episode Groupers: A Report from the National Quality Forum 

Date of Publication:
SEP 2014
Associated Project:
Episode Grouper Evaluation Criteria
Episode-based performance measurement is one approach to better understand the utilization and costs associated with certain conditions by grouping care into condition-specific or procedure-specific episodes, and episode grouper software tools are a generally accepted method for aggregating claims data into episodes. This report defines the characteristics and challenges of constructing episode groupers; determines an initial set of criteria by which episode groupers should be evaluated; and outlines the key elements of a qualitative, peer review process as a foundation for further work to evaluate episode groupers.