HCI3 Library

Search results for: Studies by HCI3 Staff

An Overview of the Risk Adjustment Methodology for PROMETHEUS Analytics

White Paper

PROMETHEUS Analytics© is perhaps the most comprehensive system available for analyzing provider performance, and developing and implementing value-based payment models around episodes of care. A critical feature of any episode grouper is the application of appropriate methods of risk adjustment…

May 15, 2016

Technical Appendix 1

The warranty allowance model division between flat fee and proportional rate

Editor’s Note: This online data supplement contains supplemental material that was not included with the published article by Francois de Brantes and colleagues, “Should Health Care Come With A Warranty?” Health Affairs 28, no. 4 (2009): w678–w687 (published…

June 20, 2012

Can Health Care Come With a Warranty?

From the time I was in grade school until just a few years ago, my parents owned a series of small neighborhood businesses. The first was a corner convenience store in an Italian neighborhood; eventually they traded up to three…

April 10, 2012

Episode of Care Analysis Reveals Sources of Variations in Costs

Objectives: To understand and reveal the under­ lying sources of inter­ and intraplan variation in a selected number of chronic and procedural episodes. Study Design: Analysis of allowed claims from 9 regional health plans covering commercially insured populations in different…

April 9, 2012

Reducing potentially avoidable complications in patients with chronic diseases

The Prometheus Payment approach.

OBJECTIVE (OR STUDY QUESTION): To determine whether a new payment model can reduce current incidence of potentially avoidable complications (PACs) in patients with a chronic illness. DATA SOURCES/STUDY SETTING: A claims database of 3.5 million commercially insured members under age…

February 7, 2012

The Potential of HIEs as Infomediaries

For more than 40 years, various health services researchers have noted the many distortions in the American healthcare economy that produce massive information assymetries and almost near opacity in the medical services delivery market.This paper comments on the potential of…

September 28, 2011

Analyzing Sources of Variation within Episode Costs:

The objective of this report is to summarize the results of a comprehensive data analysis and identify opportunities for improvement both in terms of 1) lowering costs and 2) improving quality of care using the unique features of the Prometheus…

September 28, 2011

Building a Bridge from Fragmentation to Accountability” The Prometheus Payment Model

In the current debate over health care reform, many observers are proposing new delivery structures to move U.S. health care away from fragmentation, poor performance, and dysfunction……

September 28, 2011

Should Health Care Come With A Warranty?

Many goods and services come with warranties; should health care? Analysis of one payment model shows promise and challenges.

How health care providers get paid has implications for the delivery of care and cost control; the topic is especially important during an economic downturn with persis- tent growth in health spending. Adding “warranties” to care is an innovation that…

September 28, 2011

Physicians Respond to Pay-for-Performance Incentives: Larger Incentives Yield Greater Participation

Programs that create incentives and rewards for physicians are rapidly expanding in scope and reach. …

September 27, 2011

PROMETHEUS Payment: Better for Patients, Better for Physicians

Although pay for performance is a positive development in the history of quality improvement in this country, it is generally accepted that most pay-for-performance programs do not offer a sustainable business model. PROMETHEUS Payment is a new approach to provider…

August 25, 2011

PROMETHEUS Payment®: What’s the Score?

How Scores Determine Provider Payment

The PROMETHEUS Payment® model is explicitly designed to pay providers to deliver what science says patients should receive for their specific constellation of clinical problems associated with a condition. The maximum payment amount for a provider is based upon an…

August 2, 2011

What is Prometheus Payment?

An Evidence-Informed Model for Payment Reform

Ideas about how to pay providers to improve quality and reduce costs are ground zero for many current discussions about national health reform. A variety of solutions are being touted to correct the widespread deficiencies and increase value in our…

August 1, 2011