3M™ Patient-focused Episodes (PFE) Software

Quantify patient needs over time and generate actionable insights that can help lower costs and improve outcomes.

Let’s talk about how we can help you and your organization

Fill out the form to start the conversation. A 3M representative will reach out to you soon.

  • All fields are required unless indicated optional

  • What methodology are you most interested in? (Check all that apply)

  • Select the communications you’d like to receive from 3M Health Information Systems by simply checking the box next to the content subscriptions available.
  • 3M takes your privacy seriously. 3M and its authorized third parties will use the information you provided in accordance with our Privacy Policy to send you communications which may include promotions, product information and service offers. Please be aware that this information may be stored on a server located in the U.S. If you do not consent to this use of your personal information, please do not use this system.

  • Submit

Our apologies...

An error has occurred while submitting. Please try again later...

Thank you!

Thank you for your inquiry. A 3M representative will reach out to you shortly about how you can create a masterpiece using 3M’s methodologies.

Identify patient-focused episodes using a clinical model that categorizes episodes of care to reflect a patient’s total burden of illness and comorbidities, not merely the presence of a single diagnosis.

3M PFEs are patient-centered and help identify the majority of health care spending.

3M PFEs generate extensive risk adjustment using widely adopted methodologies for inpatient hospital care, ambulatory care and baseline health status.

doctor and businessman having a discussion
3M PFEs: Patient-centered, clinically categorize and define episodes of care

3M PFEs identify the health care data that can help an organization gain insights into reducing costs and improving outcomes.


Why choose 3M PFEs?

  • a doctor talking to a patient in a hospital bed
    Patient centric, not disease specific

    In contrast to approaches that define episodes by disease with minimal recognition of the complex interplay of comorbidities, 3M PFEs are patient-centered. An episode includes all conditions and costs of caring for the patient during the episode. This is important because patients with comorbidities account for most healthcare spending.

  • doctor writing on a clipboard
    Careful, clinically defined risk adjustment

    To reflect the clinical reality that resource needs vary widely depending on comorbidities, 3M PFEs include extensive risk adjustment using widely adopted and well vetted methodologies such as the 3M™ All Patient Refined Diagnosis Related Groups (3M APR DRGs) for inpatient hospital care, the 3M™ Enhanced Ambulatory Patient Groups (EAPGs) for ambulatory care, and the 3M™ Clinical Risk Groups (CRGs) for baseline health status.

  • surgeon typing on a laptop

    The 3M PFE methodology includes more than 240 event-based episodes covering a full range of medical and procedural encounters with triggers from both ambulatory and inpatient settings. In addition, more than 120 cohort episodes cover a wide range of chronic conditions and pregnancy-related care over a one year period.

  • patient filling out information at a clinic front desk
    Flexible and suitable for payment

    3M PFEs were designed not only for analysis but also as the unit of payment. 3M PFE users have wide latitude to define various parameters such as the length of the episode window and included or excluded services. Because 3M PFEs are a clinical, categorical model, clinicians and analysts can drill into the data to gain insights on how to reduce cost and improve outcomes.

All about 3M PFEs

3M PFEs use a categorical, clinical model to classify patients into mutually exclusive categories, creating a uniform clinical language that can help identify at-risk patients, costs and inefficiencies.

  • Definition
    3M PFEs are a categorical, clinical model that defines episodes of care to reflect a patient’s total burden of illness and comorbidities, not merely the presence of a single disease. 3M PFEs simultaneously quantify the patient’s acute and post-acute resource needs, taking into account both the immediate need for care and baseline health status. The methodology was designed for payment, utilization analysis and clinical insight.
  • 3M PFEs are most attractive to organizations interested in improving systemwide healthcare performance, provider profiling and payment reform. Examples include payers, large integrated delivery systems, accountable care organizations, risk-bearing provider organizations, government agencies, employers and research groups.

    3M PFEs are designed both for analysis and for creating a bundled, incentive-based payment method. Because the 3M PFE-based payment method includes risk adjustment, it can reward provider collaboration and efficiency without requiring providers to accept insurance risk for the incidence of illness and injury. Many payers, led by Medicare, look to episodes and other alternative payment methods to reduce waste, increase coordination and improve outcomes.

  • Here are a few examples of the value 3M PFEs can bring to customers:

    • Meaningful communication to improve patient outcomes. To improve care, clinicians need data they can believe. 3M PFEs are defined in clinical terms that communicate actionable information at a sufficient level of detail. High-level analysis reveals variations and areas for potential improvement, so that the categorical nature of 3M PFE results can then lead to focused actions.
    • Bundled payment. The 3M PFE patient-centered approach greatly simplifies the administration of an episode-based payment method. It eliminates the complexity of defining which services are related to which diagnoses. This is especially important when patients have multiple diagnoses. The entity receiving the single payment is rewarded for efficiently coordinating both acute and post-acute care across multiple provider types. 3M PFEs include severity and risk adjustment, available empirically defined relative payment weights and other features needed for a successful prospective payment system.
    • Stewardship of financial resources. 3M PFEs clearly define the episode as the comprehensive unit of service. The ability to compare actual and expected resource use can help identify patterns of systematic overuse and underuse. These results serve as a starting place for further identification of possible inappropriate care, fraud, waste and abuse. For example, if a hospital’s patients have meaningfully higher post-acute care expenses compared with peer organizations, the reason may be inadequacies in inpatient care or continuity of care.
  • 3M PFE classification logic is the same for every licensee, although different organizations may use different configurations. At this time, Solventum does not offer software that replicates the PFE analysis used by specific organizations. See the list of reimbursement calculation software available for Solventum patient classification methodologies.

  • 3M PFEs use 3M APR DRGs as triggers for inpatient event episodes, 3M EAPGs as triggers for outpatient event episodes and 3M CRGs both to identify cohort episodes and risk adjust all episodes for baseline health status. Readmissions are evaluated using the 3M™ Potentially Preventable Readmissions (PPR) Grouping Software. Licensees already familiar with Solventum patient classification methodologies will easily recognize and understand many 3M PFE concepts.
  • 3M PFEs are available in the following Solventum products:

    Available to licensees on the Solventum customer support website:

    • 3M PFE Methodology Overview
    • 3M PFE Definitions Manual
    • 3M PFE Summary of Changes
    • 3M PFE Setup Guides
  • Solventum experts are available to advise health plans, government agencies, providers and other organizations on how to obtain maximum value from the 3M PFEs.

    Solventum consultants can also help payers and other organizations measure performance and identify material variation across health plans, providers and other patient populations; design pay-for-outcomes incentive methods; facilitate learning collaboratives; and provide advice on documentation and coding.

  • All data required to assign a 3M PFE are routinely collected from institutional and professional claims, including the UB-04 and CMS-1500 paper forms and their corresponding X12N 837 electronic formats. Pharmacy data in NCPDP format are optional but recommended.  Consistent, unique patient identifiers are essential. These requirements are the same as those for the 3M CRGs.

    3M PFE analysis typically involves creation of a static data set comprising at least one full year of data. Two years of data allow a full year of data to establish baseline health status by 3M CRG before a one-year episode analysis window. Some users perform rolling analyses each month or each quarter. The 3M PFEs do not need to be built into a claim-processing system.

  • Development

    In the 1980s and 1990s, the success of the Centers for Medicare & Medicaid Services (CMS) diagnosis related groups (DRGs) for hospital inpatient care prompted widespread interest in developing similar models for other applications. Since CMS DRGs define an episode as a single hospital stay, the obvious extension was to define broader episodes. For example, an episode might also include the cost of physician services and post-acute services such as rehabilitation.

    Solventum, as the contractor to CMS for Medicare DRGs, was well-positioned to develop such models. Under contract to CMS and the Medicare Payment Advisory Commission (MedPAC), Solventum prepared analyses of episodes built around Medicare DRGs that were published in 2013 in the Medicare and Medicaid Research Review¹ and in a MedPAC Report to Congress.²

    In parallel to its work developing episodes around Medicare DRGs, Solventum also developed the more comprehensive, proprietary 3M PFEs. 3M PFEs are appropriate for all populations, include both inpatient and ambulatory care and incorporate risk adjustment for baseline health status.

    Design principles

    These four principles guide the 3M PFE design:

    1. Patient-focused. Most notably, the episode clinical model focuses on an individual’s total burden of illness. This approach differs from conventional disease-centered models that face the intractable challenge of separating services; for example, heart failure requires treatment and services distinct from those needed for lung disease. This is important because patients with interacting comorbidities are precisely those who are most expensive to care for and the most complex clinically.
    2. Uniform categorical clinical model. 3M PFEs are a categorical clinical model, that is, a mutually exclusive and exhaustive set of clinical categories that differentiate individuals based on their total burden of illness. The underlying categorical model applies to all episode types, creating a uniform and stable clinical language. The model also remains unchanged across all potential configurations of episodes (window lengths, included services, etc.).
    3. Re-use well-established systems. 3M PFEs are based on 3M APR DRGs, 3M EAPGs and 3M CRGs, which are widely used for risk adjustment and payment systems.
    4. Independent, empirically derived relative weights. For each potential configuration of episodes used, a separate set of relative weights should be computed. Despite differences in configuration, relative weights reflect a stable clinical model, enabling a consistent clinical language.


    For profiling comparisons or establishing payment levels, users of an episode methodology must calculate both actual and expected resource use by episode. In setting up a 3M PFE analysis, users have broad flexibility in defining the time windows for episode identification and the 3M CRG assignment, determining which services are included and excluded and defining the readmission logic.

    3M PFE software performs two basic functions:

    1. Episode classification: Based on the patient’s claims history, each patient is assigned to event-based and/or cohort-based episodes. Event-based episodes start when a significant health care event occurs; a patient may be in only one event-based episode at a time. Cohort episodes are assigned to patients who share a common disease, condition or characteristic within a given time period. A patient may be in more than one cohort episode at the same time. Neither episode type attempts to isolate the services associated with any specific condition, but instead capture the patient’s entire resource needs during the episode. The patient’s baseline health status can be considered using the patient’s Clinical Risk Group (CRG) or Aggregated CRG.
    2. Episode accumulator: Based on the time window selected and the service categories included, actual expenditures are accumulated for each episode.

    The actual expenditures that output from the accumulator can be used to compare against expected expenditures derived from relative weights.

    The 3M PFE clinical logic is maintained by a team of clinicians, data analysts, clinical analysts, programmers and economists. The logic is proprietary to Solventum but is available for licensees to view in the online 3M PFE definitions manual. The methodology is updated annually to reflect changes in the standard diagnosis and procedure code sets and is regularly enhanced to improve the clinical logic.

    Examples of 3M PFEs

    Event-based episodes:

    • Inpatient Surgical Event (n = 51)
      1001710 Permanent Cardiac Pacemaker Implant without AMI, Heart Failure or Shock
    • Inpatient Medical Event (n = 49)
      2001340 Pulmonary Embolism
    • Outpatient Procedure Event (n = 135)
      3000360 Level II Foot Procedures
    • Outpatient Medical Event (n = 11)
      4004980 Kidney Infections

    Cohort episodes:

    • Chronic Cohort (n = 96)
      6000020 Parkinson’s Disease
    • Acute Cohort (n = 25)
      5000420 Cerebrovascular Infarction
    • Pregnancy Cohort (n = 6)
      8005401 High Risk Pregnancy w Delivery
    • Population Cohort (n = 1)
      7000000 Population

    ¹Vertrees J, Averill R, Eisenhandler, J, Quain, A, Switalski J. Bundling Post-Acute Care Services into MS-DRG Payments. Medicare Medicaid Res Rev. 2013;3(3):E1-E19
    ²Medicare Payment Advisory Commission. Approaches to bundling payment for post-acute care. Chapter 3 in Report to the Congress: Medicare and the Health Care System. Washington, DC: MedPAC, June 2013.

Learn more about 3M PFEs

Publicly available documentation, articles and reports

Please note that documents not published by Solventum do not necessarily reflect Solventum recommendations and have not been approved by Solventum. These documents are listed here for the information of readers interested in the various ways that Solventum patient classification methodologies have been applied. Also note that listing these references does not imply endorsement of Solventum methodologies by individual authors, other organizations or government agencies.

Some articles and reports are available from the publishers at no charge, while others require a fee.

Ready to take the next step?

Send us a message or speak to a 3M representative at 1-800-367-2447 (available weekdays 7 a.m. to 3 p.m. CT).

Connect with us

Discover the inspiration and information you’re looking for on the health care topics that matter most.

  • Subscribe to our newsletter

    The 3M HIS monthly email newsletter offers thought leadership and resources directly to your inbox.