Michael P. Thompson, PhD

This study reports qualitative findings from an explanatory sequential mixed-methods investigation to understand hospitals’ approaches to a novel commercial episode-based reimbursement incentive program.

Some hospitals were able to outperform others in a commercial insurer episode-based incentive program, but there was little evidence of global reductions in episode spending.

Super-utilizers place a significant clinical and financial burden on the healthcare system. The authors investigated the effectiveness of community navigators in reducing hospital utilization and costs.