LAUSR

11Background: As payors introduce APMs, there is little guidance on how episodes will be defined in subspecialty areas. We set out to define clinically relevant episodes of care, develop standardized approachs toward reducing variations in care, and implement evidence-based standardized care pathways. We chose two urologic cancer procedures- Radical Cystectomy and Robotic Radical Prostatectomy. Methods: Episode timeframes were defined: Radical Cystectomy (14 days prior, index hospitalization, 90 days post) and RALP (30 days prior, index hospitalization, 30 days post). To identify variations in care, we compared evidence-based guidelines with practice patterns, analyzed episode and index hospitalization direct costs for various surgeons, and reviewed the utilization of high cost supplies and drugs. Length of stay (LOS), readmissions, complications, and acuity were benchmarked against comparable academic medical centers. Faculty, trainees, APPs, and staff collaborated to develop care pathways, modify workfl...