Library

Library

The Patient Centered Medical Home

History, Seven Core Features, Evidence and Transformational Change

The Patient Centered Medical Home (PCMH) is a model of care articulated by principles that embrace the aspirations of the Institute of Medicine, the design of the Future of Family Medicine new model of care and The Wagner Care Model,…

February 8, 2012

Reducing potentially avoidable complications in patients with chronic diseases

The Prometheus Payment approach.

OBJECTIVE (OR STUDY QUESTION): To determine whether a new payment model can reduce current incidence of potentially avoidable complications (PACs) in patients with a chronic illness. DATA SOURCES/STUDY SETTING: A claims database of 3.5 million commercially insured members under age…

February 7, 2012

Clinical Integration Self Assessment Tool v2.1 (Network/IPA Version)

"Physicians working together, systematically, with or without other organizations and professionals, to improve their collective ability to deliver high quality, safe, and valued care to their patients and communities." -Gosfield and Reinertsen (2011)" The original Clinical Integration Self-Assessment Tool v.2.0…

February 1, 2012

Hospital Perspectives on Reducing and Preventing Readmissions

As hospital-acquired infections (HAIs) are drawing intense scrutiny from regulators and payers, hospitals are finding that practicing careful case management can help prevent HAIs and patient readmissions. Successful strategies include discharge planning, transition plans for home care and tertiary care,…

January 3, 2012

WhyNotTheBest.org

Quality Improvement Resources for Health Care Professionals

WhyNotTheBest.org was created and is maintained by The Commonwealth Fund, a private foundation working toward a high performance health system. It is a free resource for health care professionals interested in tracking performance on various measures of health care quality.…

January 3, 2012

OrthoChoice Brief

Initial Results Promising for Bundled Payment Model in Stockholm

In 2009, a bundled payment model was implemented for total hip and knee replacement on a health system level in Stockholm. In 2010, a joint study was set up in collaboration between the Stockholm County Council, Karolinska Institutet and the Institutet for…

December 14, 2011

Rockford Prometheus Pilot Case Study

The Rockford PROMETHEUS pilot was one of the original Robert Wood Johnson Foundation-funded implementation sites, which aimed to operationalize the PROMETHEUS model to address the range of issues. The objective of the pilot was to test the validity of the…

November 18, 2011

{Then} {Now}

That Was Then, This Is Now

In 2006, the Commonwealth Fund and the Robert Wood Johnson Foundation (RWJF) funded the development of the PROMETHEUS Payment methodology, a patient-centered episode of care logic that bundles payment around a particular condition or procedure. In addition to development, RWJF…

November 10, 2011

PROMETHEUS ECR SAS Freeware for CMMI Bundled Payment

This ECR Freeware has been modified specifically for the CMMI Bundled Payments for Care Improvement Initiative

In collaboration with Brandeis University and consultant G Liu, we have developed an analytic package to help all CMMI Bundled Payment Pilot applicants to (1) analyze the Medicare data provided by CMS, and (2) facilitate the filing of the application.…

October 10, 2011

Guidelines for Benefits Operations in Episode of Care Contracting

As PROMETHEUS pilot sites have expanded, and in particular, with the recent Center for Medicare and Medicaid Innovation (CMMI) push into bundled or episode payment, questions about how benefits should be operated have come to the fore. It is easy…

October 7, 2011

PROMETHEUS PAYMENT®

Pilot Assessment and Implementation Toolkit

Welcome! This toolkit is designed to provide the information you need to gain a solid understanding of the PROMETHEUS Payment model, consider the potential benefits of a pilot implementation and take action. It is meant for use by local health…

September 28, 2011

QUALIFYING FOR RECOGNITION:

pathways for physicians and practices.

AT BRIDGES TO EXCELLENCE (BTE), WE WANT ALL TOP-PERFORMING PHYSICIANS AND PRACTICES to benefit from our recognition programs. So we offer several ways to become BTE-Recognized. Our programs measure the quality of care delivery, with an emphasis on managing patients…

September 28, 2011

A Vision to Transform U.S. Health Care

The programs to make it a reality.

HCI3 – Improving Health Care Quality and Value with evidence-based incentive programs and a fair and powerful model for payment reform.…

September 28, 2011

The Potential of HIEs as Infomediaries

For more than 40 years, various health services researchers have noted the many distortions in the American healthcare economy that produce massive information assymetries and almost near opacity in the medical services delivery market.This paper comments on the potential of…

September 28, 2011

The History of the Development of the Prometheus Payment Model­ Defined Potentially Avoidable Complications.

In 2006 the Prometheus Payment Design Team convened a series of meetings with physicians that had been organized in Clinical Working Groups. These Groups focused on Cancer, Cardiac, Chronic, Orthopedic and Preventive care. Their task was to select a starter…

September 28, 2011

Analyzing Sources of Variation within Episode Costs:

The objective of this report is to summarize the results of a comprehensive data analysis and identify opportunities for improvement both in terms of 1) lowering costs and 2) improving quality of care using the unique features of the Prometheus…

September 28, 2011

Bridges to Excellence (BTE) in Practice

SwedishAmerican Medical Group, Rockford, IL

Headquartered in Rockford, Illinois, SwedishAmerican Health System serves 12 counties in northern Illinois and southern Wisconsin.…

September 28, 2011

Suggested Data Warehouse Fields for Robust Analysis

HCI3 is working with health plans throughout the country on pilot implementations to test the validity of the Evidence-informed Case Rate (ECR) models, as a means to fairly and equitable price health care services and encourage physicians, hospitals and all…

September 28, 2011

Stroke ECR Playbook

ECR Definition Summary

September 28, 2011

Severity Adjustment Fact Sheet

Severity Adjustment Model: The evidence-informed case rate (ECR) starts when an episode is triggered, a base case rate is paid and additional allowances become available for comorbid conditions and procedures that are included as part of the ECR. Money from…

September 28, 2011

Prometheus Chronic Care Quality Scorecard – SAMPLE DATA

September 28, 2011

Reliability of Prometheus PAC (Potentially Avoidable Complications) Measures

Potentially avoidable complications (PACs) for patients with one or more chronic illness include events such as emergency department visits and hospitalizations. For patients hospitalized with an acute medical illness such as AMI, pneumonia or stroke, these events may occur during…

September 28, 2011

Statement of Commitment to Providers

September 28, 2011

Quarterly Implementation Webinar

September 30th 2010

Agenda Introductions and housekeeping • Turning an ECR Analysis into actionable data Lessons Learned from the Engine Implementation to-date Using the outputs of the Engine Measuring quality of care in orthopedic procedures…

September 28, 2011

Prometheus Implementations Webinar

March 24, 2010

Agenda Introduction • 1:00–1:30TeamPilotSiteUpdates  Francois de Brantes, CEO HCI3 Sarah Burstein, Mid-Atlantic Region Elizabeth Siteman, Central Region Jessica DiLorenzo, Northeast Region Robert Smith, CBGH, Colorado Health Foundation Grant 1:30 – 2:00 Two-Channel Feedback System ␣ Doug Emery, Western Region 2:00…

September 28, 2011