Library

Library

Knee Replacement (KNEE) ECR Playbook

ECR Definition Summary

September 28, 2011

Knee Arthroscopy / Knee Repair (KNRP) ECR Playbook

ECR Definition Summary

September 28, 2011

PROMETHEUS Payment: Better Quality and a Better Business Case

Frustration with the quality of care provided by the American health care system has motivated a raft of new initiatives throughout the country. Medicare’s “voluntary” hospital reporting program to which Congress attached financial penalties for noncooperation,1 the purchasing principles of…

September 28, 2011

The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary

THE LEARNING HEALTH SYSTEM SERIES ROUNDTABLE ON VALUE & SCIENCE-DRIVEN HEALTH CARE THE HEALTHCARE IMPERATIVE Lowering Costs and Improving Outcomes Workshop Series Summary…

September 28, 2011

Excellence in Chronic Care Management Program

Improve care, decrease expenses across six major conditions

The Excellence in Chronic Care Management program encompasses six chronic conditions: congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, asthma, hypertension, and coronary artery disease (CAD). This program measures the quality and cost of care delivered in physician…

September 28, 2011

Raising the State of Care: A Custom Program to Target

six chronic illnesses and reward top-performing doctors.

By reducing potentially avoidable complications just 6%, this statewide benefits plan could save $10 million a year.…

September 28, 2011

How We’re Helping a Large Department of Health

fight back against avoidable complications.

To improve resident health and the community’s finances, we designed a scorecard that bundles a variety of measures into one robust performance assessment.…

September 28, 2011

Piloting PROMETHEUS®: Employers, Plans and Physicians

working together to reward greater quality and value.

Real payment reform won’t happen overnight. But for one employer coalition, a three-year pilot shows a promising way forward.…

September 28, 2011

What Every Employer Must Do Now

to drive down health care costs.

Know your numbers. Three key metrics can make a big difference—and you have plenty of power to improve them. If you had to spend an extra $4,000 on every person covered by your company’s health plan, what would that do…

September 28, 2011

Better Measures, Easier Reporting:

How one provider recognition program evolved over time to the benefit of all stakeholders.

How one provider recognition program evolved over time to the benefit of all stakeholders.…

September 28, 2011

Hysterectomy (HYST) ECR Playbook

ECR Definition Summary

September 28, 2011

Hypertension ECR Playbook

ECR Definition Summary

September 28, 2011

HEALTH INFORMATION EXCHANGE: FROM START UP TO SUSTAINABILITY

TELEMEDICINE SPECIAL PROJECT GRANTS: CONNECTING COMMUNITIES FOR BETTER HEALTH

There is no silver bullet for achieving sustainability in health information exchange. As much as we would like to report a spectacular finding that eluded all others investigating the question of sustainability, it became more and more apparent as we…

September 28, 2011

Hip Replacement (HIPR) ECR Playbook

ECR Definition Summary

September 28, 2011

Prometheus Payment Model

Application to Hip and Knee Replacement Surgery

The Prometheus Payment Model offers a potential solution to the failings of the current fee-for- service system and various forms of capitation. At the core of the Prometheus model are evidence-informed case rates (ECRs), which include a bundle of typical…

September 28, 2011

Hypertension Care Link – Denominator and Numerator Documentation

September 28, 2011

HIPAA BUSINESS ASSOCIATE AGREEMENT

September 28, 2011

License Agreement

September 28, 2011

Getting the Team Paid: How Medicare Physician Payment Rules Impede Quality

In 1998, the National Quality Roundtable proclaimed the pressing need to change the American health care system to deliver more reliable and better quality care. At its best, health care in the United States is superb. Unfortunately it is often…

September 28, 2011

Gastro-esophageal Reflux Disease (GERD) ECR Playbook

ECR Definition Summary

September 28, 2011

Gall Bladder Surgery / Cholecystectomy (GALL) ECR Playbook

ECR Definition Summary

September 28, 2011

Building a Bridge from Fragmentation to Accountability — The Prometheus Payment Model

In the current debate over health care reform, many observers are proposing new delivery structures to move U.S. health care away from fragmentation, poor performance, and dysfunction……

September 28, 2011

Bridges to Excellence (BTE) in Practice

Family Doctors, LLC, Swampscott, MA

Family Doctors, LLC, opened in 1948 and is now comprised of eight family medicine physicians, a gynecologist, three nurse practitioners, a registered dietician and a clinical psychologist. The staff manages upwards of 40,000 patient visits per year.…

September 28, 2011

ECR® Engine Overview

A tracking and accounting engine is required to make the PROMETHEUS Payment® Model operational. We can provide one, or help you develop your own.

The PROMETHEUS Payment® model is a reimbursement solution that rewards providers for coordinating and delivering high quality, efficient care. It packages payments around a comprehensive Episode of Care (EOC) for a single illness or condition. The costs of treatments are…

September 28, 2011

PROMETHEUS Payment ECR Contracting Strategies

Agenda Myth Busting Prospective vs. Retrospective Payment CFO’s Dilemma Changing the Unit of Account Health Plan as Financial Integrator ACOs and Medical Homes Negotiating Risk Corridors Product Development…

September 28, 2011