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Evidence-Based Health Care Payment Test Sites Chosen

May 22, 2008
Related Topics: Medical Benefits Law, Health and Wellness, Latest News
Two cities have been selected as test sites for a health care payment model based entirely on evidence-based medical guidelines.

Prometheus Payment Inc. has selected Rockford, Illinois, and Minneapolis as the initial pilot test sites. It will work with local health care coalitions and existing health plan payment systems. Two other locations will be announced soon and the experimental payment system will be implemented in all four locations by January 2009.

The payment model, which was developed by a group of experts in health care economics, law, policy, health plan operations and performance measurement, has also received a $6.4 million grant from the Robert Wood Johnson Foundation, which will help fund the pilot program.

Washington-based Prometheus Payment will pay providers based on what it costs to deliver only the care that it says science has proved to be appropriate for specified conditions. This differs from traditional fee-for-service, which critics say encourages high volumes of service, and capitation, which can induce health care insurance providers to limit access to care.

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Filed by Joanne Wojcik of Business Insurance, a sister publication of Workforce Management. To comment, e-mail
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