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Reimbursement Issues

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  • Topic: Reimbursement issues
  • Topic: Evidence-based care
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Child FIRST Develops an Evidence-Based Early Childhood Intervention

February 5, 2013 | Program Result Report

Child First is a home-based early childhood intervention that works with the most vulnerable very young children and their families to reduce serious emotional disturbance, developmental and learning problems, and abuse and neglect.

Building a Bridge from Fragmentation to Accountability

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.

What are Prometheus Payment Evidence-Informed Case Rates?

September 4, 2009 | Issue Brief

This brief explains Evidence-informed Case Rates (ECRs), the core element of the PROMETHEUS Payment model.

Quality-Based Payment for Medical Groups and Individual Physicians

July 1, 2009 | Journal Article

This survey on quality-based payment found that the prevalence of external performance bonuses paid by insurers to large medical groups is larger than the prevalence of performance bonuses paid by the medical groups to the primary care and specialist physicians.

What is PROMETHEUS Payment?

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.

Prometheus Payment

January 1, 2009 | Report

This report describes the PROMETHEUS scorecard approach, the principles of scoring, the sources of the measures, how scores are calculated and the impact on payment.

The Impact of Profitability of Hospital Admissions on Mortality

April 1, 2013 | Journal Article

When hospital service line profit goes down, mortality goes up.

Testing PROMETHEUS Payment

September 17, 2012 | Program Result 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.

Seizing Opportunities Under the Affordable Care Act for Transforming the Mental and Behavioral Health System

February 1, 2012 | Journal Article

Provisions of the Affordable Care Act offer extraordinary opportunities to insure many more people, reimburse previously unreimbursed services, integrate care using new information technology tools and treatment teams, confront complex chronic comorbidities, and adopt underused evidence-based interventions.

Child First Conference

June 2, 2011 | Audio

Presentation from the 2011 Child First Conference.

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