As U.S. policymakers debate various approaches to reform the nation’s ailing health care system, efforts to improve quality and reduce costs have never received more attention. One potential solution that is gaining support is to restructure primary care practices to incorporate essential principles of the “patient-centered medical home” clinical delivery model. Some early evidence shows that aggressive clinical care coordination, intense communication with patients, concentrated adherence to evidence-based measures and attention to avoiding hospitalization results in better-quality care being delivered at a lower overall cost. The PROMETHEUS Payment model is designed to encourage these better care patterns and can support the creation and sustainability of medical homes.
By avoiding the pitfalls of current and past incentive models, payment can be reformed, and primary care practices can return to the solid and central place they deserve in a better American health care system. At the core is recognition that existing fee-for-service (FFS) and capitation-based payment systems encourage volume- driven health care rather than value-driven health care. Providers are rewarded for “doing things” (either too many or not enough), rather than delivering quality services that are proven to keep people healthy, reduce errors and help avoid unnecessary care.