PROMETHEUS Payment: What's The Score: How Scores Determine Provider Payment

Publication Date: March 2009

Publisher: Prometheus Payment, Inc.; Robert Wood Johnson Foundation; Robert Wood Johnson Foundation

Author(s):

Research Area: Health

Type: Report

Abstract:

An essential element of what makes PROMETHEUS Payment® different from other payment systems and typical pay-for-performance models is that payments depend on the scores that the providers and their clinical collaborators earn under the model’s comprehensive scorecard. Realizing the maximum potential payment for a particular episode of care as calculated by the PROMETHEUS Evidence-informed Case Rates® (ECRs) depends on the scores that every provider treating the patient earns under the scorecard. To create a very clear incentive for clinical collaboration, the final scores depend 70 percent on what the individual provider does, and 30 percent on what every other provider treating patients for that condition has done.

This report describes the PROMETHEUS scorecard approach, the principles of scoring, the sources of the measures, how scores are calculated and the impact on payment. As one of the first elucidations on the basics of the scoring methodology and conceptual framework, this report demonstrates how PROMETHEUS rewards good care and yields better results for both patients and providers.