In 2006 the Prometheus Payment Design Team convened a series of meetings with physicians that had been organized in Clinical Working Groups. These Groups focused on Cancer, Cardiac, Chronic, Orthopedic and Preventive care. Their task was to select a starter set of episodes (Evidenceâ€informed Case Rates or ECRs) that could be fully defined by the each group, which included:
- Selecting clinical practice guidelines for those conditions;
- Determining the natural boundaries of the ECR;
- Providing a rigorous estimate of the base of the ECR, including the total units of service and the type of provider responsible for delivering those services;
- Establishing a reasonable set of performance measures that should be used to evaluate the clinical performance of providers delivering the services included in the ECR;
- Identifying routine complications that are prevalent for patients that don’t receive optimal care;
- Participating in and supervising the data modeling of the ECR to determine the extent to which the results were valid; and
- Creating estimates for the warranted variation of services that should be added to the base.