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Related Concept Videos

Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
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Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Introduction To Health Care Delivery System01:18

Introduction To Health Care Delivery System

The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
Methods of Documentation III: PIE01:21

Methods of Documentation III: PIE

Problem-intervention-evaluation (PIE) is a systematic approach to documentation used in healthcare settings for clinical decision-making and patient care planning. It is a structured approach to organizing patient data based on problems, interventions, and evaluations. Here's a breakdown of its key features and considerations:
Health Information Technology and Healthcare Information System01:30

Health Information Technology and Healthcare Information System

Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:

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The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
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The PROMETHEUS bundled payment experiment: slow start shows problems in implementing new payment models.

Peter S Hussey1, M Susan Ridgely, Meredith B Rosenthal

  • 1RAND Corporation, Arlington, Virginia, USA. peter_hussey@rand.org

Health Affairs (Project Hope)
|November 10, 2011
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Bundled payment models aim to improve healthcare by paying for episodes of care. However, early pilot projects like PROMETHEUS Payment faced significant implementation challenges, delaying expected benefits.

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Area of Science:

  • Health policy
  • Healthcare economics
  • Payment reform

Background:

  • The US healthcare system faces challenges attributed to the fee-for-service payment model.
  • Alternative payment models, such as bundled payments, were proposed in the Affordable Care Act of 2010 to address these issues.
  • Bundled payment involves a single payment for all services related to a defined clinical episode.

Purpose of the Study:

  • To evaluate the initial implementation and challenges of the PROMETHEUS Payment bundled payment pilot project.
  • To assess the feasibility and early outcomes of bundled payment models in a real-world setting.

Main Methods:

  • Evaluation of a pilot bundled payment project (PROMETHEUS Payment).
  • Analysis of implementation progress and challenges across three pilot sites.
  • Assessment of timelines and reasons for delays in contract execution and payment.

Main Results:

  • The PROMETHEUS Payment pilot project encountered substantial implementation challenges.
  • None of the three pilot sites had executed bundled payment contracts or made payments by May 2011.
  • Delays were primarily due to the complexity of the bundled payment model and integration with existing healthcare systems.

Conclusions:

  • Bundled payment models show promise but require significant time and effort to realize their intended benefits.
  • The complexity of bundled payment implementation necessitates careful planning and adaptation.
  • Further experience and refinement are needed for successful adoption of bundled payment reforms.