Designing an Episode-based Benefit Plan

This report analyzes an Episode-based Benefit Plan (EBP) design that could be offered to members enrolled in commercial health plans. In this EBP, members would be offered a prospectively defined budget for services within an EOC, while providers would be contracted to manage the cost and care of services within an EOC. This report provides considerations for a EBP cost-sharing framework, the impact of key plan design parameters, and discussion of the limitations, considerations, and challenges for implementing an EBP.

This report was commissioned by Signify Health.