Health Plans

Health Plans

HEALTH PLANS – PARTICIPATE IN PROMETHEUS Payment

Make change happen! Launch a PROMETHEUS pilot.

Health plans find themselves increasingly under the gun to contain costs and enhance quality. New requirements to conform to regulations under the Patient Protection and Affordable Care Act will only make that pressure more intense.  In PROMETHEUS pilots now underway, plans like Independence Blue Cross have begun the critical work of transforming today’s fragmented and inefficient system into one that is far more integrated and accountable. We believe PROMETHEUS will pay providers fairly, improve quality for patients, reduce some of the current administrative burdens, and generate transparent information to spur continuous improvements. But to prove it, we need your help.

A pilot implementation requires the voluntary participation of local stakeholders. During a pilot, you will “plug into” the PROMETHEUS Payment® model Engine. This is a combination claims tracking/financial accounting system, with a scorecard that uses claims and other data, including medical record data, to measure the quality of care being delivered to patients. Payers and providers will not have to modify their existing claims systems. Instead, the Engine will work in the background.

To learn more about implementations, see the PROMETHEUS Tools & Resources.