In a new report by The Commonwealth Fund, researchers describe a new payment model designed to address the flaws of traditional payment methods such as capitation. The model is meant to improve healthcare quality, lower administrative burden, enhance transparency, and support a patient-centered, consumer-driven environment.
Developed by the not-for-profit Prometheus Payment, the model is based on the “evidence-informed case rate”--a single, risk-adjusted payment given to providers across healthcare settings to care for a patient diagnosed with a specific condition or for a specific procedure. Payment amounts are based on the resources required to provide care as recommended in the best available clinical guidelines.
To further promote quality care, the Prometheus model calls for a portion of the payment to be withheld and distributed according to various performance measures. Read the overview.
