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Step 1: Statement of Commitment from CEOs


The first step of implementing PROMETHEUS is to obtain formal commitment from the CEOs of the participating payer and provider organizations, or whoever is in charge of use of funds or discretionary spending. These commitments can be expressed through letters of commitment.


LESSON LEARNED: Formal Commitment from Senior Leadership


It is essential to have the support and commitment of the senior leadership from all parties involved in the implementation. It is crucial they take an active role in the development and implementation of the pilot throughout the entire process. From the experience of our pilot sites, it is in large part the Senior Leadership who can foster (or if they are not committed, suppress) the sense of urgency necessary to implement such a large scale program as this. Though in the past our pilot sites have signed letters of commitment and the idea of this letter is not new, for future implementations we require that these letters be signed by the CEO of each participating company, or whoever is in charge of use of funds, to ensure company-wide commitment to the project and to ensure the project moves along at a sufficient pace.


Some participating organizations may also include smaller companies that would be involved in the pilot. In this case, it is also necessary to obtain formal commitment of the CEO or person in charge of funds of these smaller companies.

These statements of commitment are essential because implementing a PROMETHEUS pilot must fit within the vision of the organization. It requires the commitment of multiple resources, appropriate allocation of resources, and the alteration of billing systems and contracts. These letters of agreement must express these requirements, as well as stating that PROMETHEUS will be a priority for the organization, and that the organization understands and feels a sense of urgency to improve quality of care and cost efficiency.


LESSON LEARNED: Sense of Urgency


Potential pilot participants should feel a sense of urgency to move away from fee for service to improve quality and reduce costs. Participants who did not consider PROMETHEUS as a corporate priority, or who did not feel a strong need to improve quality or reduce costs experienced delays in the implementation process. This critical success factor relates back to all of the other lessons learned mentioned in this write up. If any of these requirements are unfulfilled, it can decrease the momentum of the project, affecting an organization’s sense of urgency to implement PROMETHEUS in a negative way.


Useful Tools:

Statement of Commitment from CEOs of Payers

Statement of Commitment from CEOs of Providers

Sample Project Plan  This is a sample Project Plan which includes a Timeline for Implementation and an Estimation of Resources. Organizations should use this plan for guidance once they decide to implement PROMETHEUS.



Previous:  Preliminary Step: Initial Data Analysis

Next:  Step 2: Engagement of Payers and Providers