The Prometheus Analytics® were developed to analyze claims data to create an episode of care that can be used for value-based payment models and performance evaluation in order to improve the quality of care and patient outcomes. Of note, the products in the suite contain all the core components and logic to fully evaluate and support payment reform models by helping you determine:
- What kinds of reform will be most effective and where the reform should be focused
- The potential for savings or improvement of care
- Who are the most efficient and highest quality providers
Prometheus Analytics contains key features that no other analytical system currently offers:
Prometheus Analytics separates costs of “typical” care from costs associated with potentially avoidable complications, or PACs. PACs, at the core, are events that negatively impact patients and are controllable by providers. The separation of PAC from Typical costs creates performance comparisons of providers as a high PAC rate can be an indicator of low quality whereas a low PAC rate can be associated to high quality care. Complications can be a significant source of variation in the total costs of an episode of care. When physicians and hospitals do a deep dive into PACs they can create a plan to decrease overall costs while improving the quality of care.
Prometheus Analytics is comprised of an overarching clinical logic in which episodes are associated with one another. This allows inferences about costs of care at many different levels and can even help determine the appropriateness of procedures in managing patients with certain conditions.
While most analytical systems typically have static rules, the Prometheus Analytics allows for flexibility and parameter changes within episodes. This helps to customize episodes to fit customer needs based on what the analysis is being used for (i.e. bundled payments, cost and quality analysis). The core components of Prometheus Analytics provide a complete and accurate system from which decisions on incentive structures and new payment models can be made. Each of the components, which have been rigorously tested and validated, encompasses valuable elements that apply to the overall goal of reducing costs and improving quality based on existing claims data analysis.
By bringing economic incentives in line with the medical profession's strong desire to improve patient health, Prometheus creates an environment where doing the right things for patients helps providers and insurers do well financially. And it does this without introducing new administrative burdens or changing the way patients access care.