Bundled payment models assign a fixed, negotiated fee to cover a set of treatment services, encouraging providers to manage costs, while meeting high-quality care standards.
This resource provides guidance and templates to help organizations work with commercial payors to develop successful and compliant bundled payment and shared savings arrangements.
Though the strategy sounds simple, implementing a different way to pay for care across health systems and communities is a complex undertaking. This brief from Aligning Forces for Quality offers four steps that organizations considering a bundled payment pilot should follow.
In this Health Affairs blog post, Senior Program Officer Michael Painter discusses different RWJF-funded projects testing the bundled payment model.
This article from Health Affairs discusses how policy-makers must set base payment rates for episodes of care and update the rates over time to reflect changes in the costs of delivering care.
Created by the Health Care Incentives Improvement Institute, the PROMETHEUS model packages payment around a comprehensive episode of medical care that covers all patient services related to a single illness or condition. This results report provides qualitative and quantitative analyses of the pilot.
This issue brief from the Urban Institute presents a frank assessment of the merits and drawbacks of two payment models—bundled payments and global capitation—through a debate between Francois de Brantes and Robert Berenson.
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February 27, 2011 | Toolkit
Measures are based on commonly accepted clinical guidelines or expert opinions that define the best methods for treating a given condition from beginning to end.
September 17, 2012 | Program Results Report
The Health Care Incentives Improvement Institute furthered the development and pilot testing of its Prometheus bundled payment model. Researchers at RAND and the Harvard School of Public Health evaluated the initiative at three pilot sites.
November 1, 2011 | Journal Article
One of the leading alternative payment models proposed in the Affordable Care Act of 2010 is bundled payment, which provides payment for all of the care a patient needs over the course of a defined clinical episode, instead of paying for each discrete service. We evaluated the initial "road test" of PROMETHEUS Payment, one of several bundled payment pilot projects.
February 28, 2011 | Toolkit
Toolkit is designed to provide the information needed to gain a solid understanding of the PROMETHEUS Payment model, consider the potential benefits of a pilot implementation and take action.
February 27, 2011 | Toolkit
Funded by RWJF, the current pilot implementations are designed to test the validity of the PROMETHEUS model.
July 1, 2010 | Issue Brief
Updates from the PROMETHEUS Payment Initiative and pilot sites.
September 10, 2009 | Journal Article
The PROMETHEUS Payment approach seeks to promote and reward high-quality, efficient, patient-centered health care by using a novel method to pay hospitals and physicians and other providers. The PROMETHEUS Payment model consists of three components: evidence-informed base payments with patient-specific severity adjustments and an allowance for potentially avoidable complications.
September 4, 2009 | Issue Brief
This brief explains Evidence-informed Case Rates (ECRs), the core element of the PROMETHEUS Payment model.
June 10, 2009 | Issue Brief
This brief explains the three essential elements of PROMETHEUS Payment and how it offers a realistic, rational and sustainable blueprint for a new health care payment system.
May 1, 2009 | Report
In analyzing national claims data, the PROMETHEUS Payment developers found that a significant percentage of total cost of care spent today on six chronic diseases is attributable to "Potentially Avoidable Complications."