If the cost of care exceeds the flat rate payment, the physician must make up the difference—providing a powerful incentive to manage the patient carefully, she said.
The Prometheus system is risk adjusted and sustainable as a business model, Ms. Gosfield said. In addition, it provides certainty in payment, is transparent and easy to administer, reduces malpractice liability, improves clinical guideline quality, and gives physicians more control, she said.
Gosfield cautioned that the system is complicated and will incur transitional costs, especially if it becomes widely adopted while other payment systems remain in place at the same time.