The Prometheus Payment Engine
HCI3 has contracted with vendors to develop an engine for PROMETHEUS Payment. In order to implement PROMETHEUS Payment via a scalable solution, an implementation site must plug into an engine. The engine is a combination of a claims tracking and financial accounting system, along with a scorecard that uses both claims and other data, including medical record data, to measure the quality of care that is being delivered to patients.
The engine is a clinically based, financial “credit/debit” system that reconciles the actual cost of care against the predicted cost of care for any given episode using existing claims data. The engine automatically calculates patient-specific evidence-informed case rates (ECRs), while also including an allowance for potentially avoidable complications (PACs). Upon the conclusion of an ECR, the engine will automatically and retrospectively tally actual accumulated costs versus predicted costs for Scorecard analysis.