McKesson First to Automate New Version of PROMETHEUS Episodes
OREANDA-NEWS. Today McKessonEpisode Management™ released 22 new episodes based on the industry leading PROMETHEUS Payment ® Evidence Informed Case Rate (ECR) definitions. This makes McKesson Episode Management™ the first automated bundled payment solution to support the latest PROMETHEUS model. This will help payers move from small pilots to full-scale programs by enabling the automation of fee-for-service claim bundling for fast and correct adjudication and payment.
The 22 episodes represent approximately 35 percent of commercial payers’ healthcare spend1 and are the first milestone to arise from a previously announced partnershipbetween McKesson and the Health Care Incentives Improvement Institute (HCI3) to advance adoption of healthcare payment reform. The episodes are also the first in a planned series of PROMETHEUS ECRs intended to cover up to 80 percent of U.S. medical spend.
This first content release covers a significant range of episodes appropriate for bundling, including procedural episodes like hip replacement, angioplasty and endoscopy; acute medical events such as stroke, heart attack and pneumonia; chronic conditions including diabetes, congestive heart failure and coronary artery disease; and obstetrical episodes such as pregnancy, normal delivery and c-section.
“Now healthcare organizations can scale value-based programs to promote quality care and reduce administrative and medical costs,” said Carolyn Wukitch, Senior Vice President of McKesson Health Solutions. “We’re ready to help any health plan ramp-up bundled payment programs using PROMETHEUS so they can get the most value from the model. This significant increase in content is what our customers expect from the leader in claims payment management.”
Franзois de Brantes, executive director of HCI3, agrees: “With this next step in our partnership, McKesson and HCI3 are demonstrating that the PROMETHEUS model is suitable for health plans and healthcare providers of all sizes and can reliably scale from the smallest pilot to the largest bundled payment program. We’re thrilled to be working with an industry leader like McKesson, who can automate what we believe to be is the best episode of care model in a practical way.”
PROMETHEUS bundles payment for an episode of medical care that includes all patient services related to an illness or condition. It’s an evidence and value-based model designed to help employers, payers, and providers work together to increase efficiency and pay for the quality, not quantity, of care. By bundling payment, care is better coordinated among physicians, hospitals and other providers.