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View Prometheus materials and forms for digestive and gastrointestinal disease here.

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Neonatal Intensive Care Units (NICU) are typically reserved for infants with serious issues that require highly specialized care. However, analyses of Medicaid claims using PROMETHEUS Analytics found that NICU designation varies widely among facilities. These variations in rates of use, costs, and lengths of stay can seriously impede a facility’s ability to achieve savings under value-based bundled payments. By better understanding this variation and its sources, facilities can take steps to standardize assignment of newborns to NICU and, by extension, reduce costs of postpartum care.

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These analytics form the backbone of PROMETHEUS Payment, a bundled payment model developed by the Health Care incentives Improvement Institute, which joined forces with Altarum in 2017. The design team included experts in health care law, quality measurement, economics, benefits, operations, and related fields. The Robert Wood Johnson Foundation provided grants to create, evaluate and pilot the model. The Commonwealth Fund, New York State Health Foundation, and Colorado Health Foundation also provided critical support. Today, PROMETHEUS Analytics are working to improve health care quality and value for health systems, Medicaid organizations, health plans and employers across the U.S.


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To rein in Medicaid costs, the New York State Department of Health (NYS DOH) decided to try value-based delivery and payment models. PROMETHEUS Analytics were used to create a roadmap for design and implementation, and identify the features most likely to lead to success. To meet aggressive improvement targets, payments are no longer based on services delivered, but on results achieved in system transformation, clinical management and population health – value rather than volume.

Associates episodes to one another in a clinically relevant way to help progressively build a comprehensive view of patient care management. This logic helps identify the potentially inappropriate use of procedures, while allowing the creation of severity-adjusted budgets for poly-morbid patients.

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Assigns health care services and associated costs to specific episodes, splitting the costs among relevant episodes. This creates great transparency in how costs are assigned to episodes, eliminating the “black box” problem found in all other groupers.

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A large New England health system used PROMETHEUS Analytics to measure its cost performance for several episodes of care. The health system found it beat the market average consistently for routine colonoscopies. However, after learning it placed below average for gall bladder surgeries and knee arthroscopies, the organization directed significant resources toward those service lines and populations. After decreasing costs associated with potentially avoidable complications (PACs) by 35%, the health system soon began to outperform market averages for these two procedures as well.

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Separates typical costs from costs related to potentially avoidable complications (PACs). PACs are deficiencies in care that cause harm to patients, and account for a significant percentage of spending on chronic conditions, acute hospitalizations and procedures.

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Horizon Healthcare Services of New Jersey used PROMETHEUS Analytics to implement bundled payments for nine conditions and procedures. More than 12,000 care episodes were completed under the program. Key benefits included quicker average recovery times after orthopedic surgeries, lower rates of unnecessary C-sections, lower costs for hip replacements, and fewer readmissions after knee arthroscopy. Costs were contained well enough for Horizon to pay out $3 million in shared savings to 51 participating specialty medical practices.