Date of Award


Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Ruth McCorkle


CMMI’s Episode Based Payment initiatives propose a large opportunity to reduce cost from waste and variation and stand to align hospitals, physicians and post acute providers in the redesign of care that achieves savings and improve quality. Community-based organizations are at the forefront of this care redesign through innovative models of care aimed at bridging gaps in care coordination and reducing hospital readmissions. This article describes a community-based provider’s approach to participation under the Bundled Payment for Care Improvement Initiative and a 90-day model of care for Congestive Heart Failure in home care.

Open Access

This Article is Open Access