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Nonprofit Promotes New Provider Compensation Approach

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Prometheus Group Inc. says it has developed a way to pay doctors and other providers based partly on whether patients receive the right amount and type of care.

Health policy experts formed Prometheus, Newtown, Conn., in an effort to update provider compensation methods.

Prometheus has dubbed its proposed solution the Evidence-Based Case Rates system.

“An ECR is a payment rate that establishes the total amount to be paid to all providers to care for a patient through an entire episode of care according to what the evidence says is the best protocol in clinical practice guidelines,” according to Prometheus organizers.

If a payer uses the ECR system, 10% to 20% of the payment will go into a “performance contingency fund” linked to patient satisfaction, cost efficiency and the outcome of the care.

Some of the ECR payment will depend on the performance of the providers that a provider refers patients to.

Prometheus will start by trying to apply the ECR system in test markets to compensation for preventive care, routine care, joint replacements and treatment of lung cancer, colon cancer, diabetes, high blood pressure, high cholesterol and heart problems.

Michael Pine and Associates Inc., Chicago, and the RAND Corp., Santa Monica, Calif., are partners in the Prometheus development effort, organizers say.


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