Prometheus’ new payment model seeks to reform the toxic health care payment system

Unveiled on September 13, non-profit PROMETHEUS Payment™, Inc. was established by a team of experts in health care economics, law, policy, health plan operations and performance measurement to create a payment infrastructure that improves quality and distributes risk evenly between the clinical and insurance sides of the system. The payment infrastructure developed by PROMETHEUS also increases transparency and more accurately reflects the patient’s needs.

PROMETHEUS uses Evidence-Based Case Rates™ (ECRs™) to determine the total resources required to deliver clinically appropriate care. An ECR is a payment rate that calculates what it will cost for a provider to care for a patient during his/her entire episode of treatment. It differs from other payments structures, some of which encourage a high volume of service or put caps on what services providers give.

“With PROMETHEUS we have set out to help payers and purchasers reform what the Institute of Medicine has called a toxic payment system,” said Suzanne Delbanco, CEO of The Leapfrog Group and a Board member of PROMETHEUS Payment, Inc. “To reform health care payment, we examined why our current payment system fosters poor care and devised a method for mitigating these effects and motivating effective health care delivery.”

See www.prometheuspayment.org for more information and a copy of the White Paper.

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