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.
For more information, visit www.prometheuspayment.org.
Filed by Joanne Wojcik of
Business
Insurance, a sister publication of Workforce
Management. To comment, e-mail editors@workforce.com.