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This is the guiding principle of a pilot payment model called Prometheus, which, by January 2010, will be used to calculate insurance coverage for 80,000 workers in Rockford, Ill., and has already caught the eye of the White House. Why? Because it turns the current insurance reimbursement system on its ear. See the top 10 medical breakthroughs...
Taking the congestive-heart-failure example, here's how the payment scheme would work: A slightly overweight 60-year-old heart-failure patient comes in with coronary-artery disease and acid-reflux disease. According to a Prometheus algorithm, this patient should cost $20,750 a year to treat - including office visits, medications, blood-pressure monitoring and an allowance for complications. The incentive for the heart patient's doctor to spend less than $20,750 is that he gets to keep a portion of the difference (assuming that the patient was managed properly and happy with the outcome). And the best...
...Prometheus project is named after the Greek god of forethought, but it's also a lengthy acronym for "Provider payment reform for outcomes, margins, evidence transparency, hassle reduction, excellence, understandability and sustainability...
...five years since Jed Dorfman has been running Camp Walt Whitman, a posh haven complete with waterskiing and private boats in Piermont, N.H., that charges as much as $9,450 for a seven-week stay, he has had to work out payment plans and extend deadlines to help one or two families. Until this year, that is. A few months ago, with the enrollment deadline fast approaching, he called the families of several kids who had been coming to camp for years but hadn't signed up yet for 2009. He heard details about grandparents who had footed the bill...
Camps have been eager to negotiate. Some are even leaving it up to parents to decide what they can afford. In New York City, overnight YMCA camps have started a tiered-payment system in which parents essentially use an honor code to determine whether they need to get up to a $400 discount on the $1,397 tuition for the two-week sessions. As of June, 43% of enrollees had opted to pay the full amount, 13% took $200 off and 44% took all $400 off. (Read "Recession Shopping: 10 Things to Buy Right...