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Prometheus Payment Blog
Posted on Mar 28th, 2009 at 9:29am.
In late May our practice began delving into the world of Lean Management (an improvement tool based on the Toyota Production Model). Some hospitals, most notably Virginia Mason Medical Center, Seattle, have been applying this methodology successfully to the healthcare industry. We’ve already spent 6 solid days with cross functional teams to look at our scheduling and office visits in one of our offices. As I was reviewing the results of the data I was struck by the following thought.
Toyota doesn’t repair the cars it makes on the same assembly line on which the car is made. But in healthcare we do. In a cardiologist practice we see a new patient. Under the current payment system this is when we are most profitable because there are legitimate reasons for a battery of tests. Follow-up visits are less profitable because the opportunity for legitimate testing is greatly reduced. Yet every time we see a new patient we are creating the need to see the patient at least once a year, sometimes many more times. And every time we see the follow-up patient we fill the slot in which we could have seen a new patient. So there is a downward spiral of profitability with every new patient we see.
With Prometheus that downward spiral doesn’t exist. You are paying to “do the right thing” for the patient which by design has a margin included. Keep up the good work!
John
John J. Morris, CMPE - Executive Director
Associated Cardiovascular Consultants, PA
63 Kresson Rd, Ste 101
Cherry Hill, NJ 08034-3200
Phone: (856) 673-1320
Fax: (856) 428-2416
Email: jmorris@accnj.com
Web: www.accnj.com
Posted on Nov 4th, 2008 at 8:18am.
Posted on Nov 4th, 2008 at 8:18am.
Posted on Nov 4th, 2008 at 8:18am.
Posted on May 17th, 2008 at 12:17pm.
To model ECRs in a way that would be credible, realistic, and accurately reflect the clinical delivery of care, Prometheus gathered experts in the field and convened five working groups, consisting of medical professionals, health care researchers, and data modeling experts. The working groups looked at criteria like prevalence, costs, treatment variation, coordination, and reimbursement, among others. Then, they developed the scope of each ECR, by examining issues like the standard work-up required to diagnose the condition, the services covered by the ECR, and criteria for successful completion of care. To develop an estimate of the base ECR payment, the groups walked a typical patient step-by-step through the relevant clinical practice guidelines. The process of developing ECRs is evolving. We encourage and welcome comments and suggestions on how to improve the models presented herein. It is our intent to make this developmental effort open to all, fully transparent, and an evolving set of models that will benefit from the collective input of health care services researchers and experts from all over the world.
Posted on May 17th, 2008 at 12:02pm.
To model ECRs in a way that would be credible, realistic, and accurately reflect the clinical delivery of care, Prometheus gathered experts in the field and convened five working groups, consisting of medical professionals, health care researchers, and data modeling experts. The working groups looked at criteria like prevalence, costs, treatment variation, coordination, and reimbursement, among others. Then, they developed the scope of each ECR, by examining issues like the standard work-up required to diagnose the condition, the services covered by the ECR, and criteria for successful completion of care. To develop an estimate of the base ECR payment, the groups walked a typical patient step-by-step through the relevant clinical practice guidelines. The process of developing ECRs is evolving. We encourage and welcome comments and suggestions on how to improve the models presented herein. It is our intent to make this developmental effort open to all, fully transparent, and an evolving set of models that will benefit from the collective input of health care services researchers and experts from all over the world.
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