Expanding Health Care Coverage

Grantee Name

Bridges to Excellence, Inc.

Funding Area

Expanding Health Care Coverage

Publication Date

May 2015

Grant Amount


Grant Date:

July 2009–March 2012

The rising cost of health care has imposed economic burdens on families, employers, and governments at every level.

While there is no simple formula for lowering the growth in health care costs, stakeholders and policymakers are making efforts to reduce the cost of care without compromising quality. In 2009, NYHealth awarded Bridges to Excellence—a program of the Health Care Incentives Improvement Institute—a grant to launch two payment reform pilot programs that offered incentives for physicians and hospitals to collaborate, improve the quality of care, and reduce costs.

Outcomes and Lessons Learned

  • Developed the PROMETHEUS Payment model by accessing and analyzing the claims data of various health plans (including HealthNow, HealthPlus, HealthFirst, and Montefiore Medical Group). In addition to NYHealth funding, development of this model was supported by the Robert Wood Johnson Foundation, Commonwealth Fund, and Colorado Health Foundation; and
  • Demonstrated the model’s potential impact to health care providers by quantifying the savings it could generate based on case rates for six key chronic conditions.

Bridges to Excellence faced numerous challenges in its attempt to launch the pilots and was ultimately unable to do so during the grant period. It was unable to garner adequate support from health plan leadership and acquire the necessary data. It also faced limited resources dedicated to data representation and analysis during a period of time when interest in New York State payment reform was less heightened. After the close of the grant period, Bridges to Excellence reported that one pilot program was successfully adopted among HealthNow and providers in Buffalo to set bundled payments for cardiac surgery.