Medicare's bundled payment pilot for acute and postacute care: analysis and recommendations on where to begin.
Medicare's bundled payment pilot for acute and postacute care: analysis and recommendations on where to begin.
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DOI：
10.1377/hlthaff.2010.0394
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发表时间：
2011-09
期刊：
影响因子：
--
通讯作者：
Newhouse JP
中科院分区：
文献类型：
--
作者：
Sood N;Huckfeldt PJ;Escarce JJ;Grabowski DC;Newhouse JP
在国家支付捆绑试点计划中，一部分医疗保险提供者将在医院接受一次急性护理，然后在熟练的护理或康复机构、患者家中或其他适当的环境中接受急性后护理。本文探讨了捆绑支付的承诺和陷阱，并解决了试点的两个重要设计决策：包括哪些条件，以及一集应该多长。我们对医疗保险数据的分析发现，髋部骨折和关节置换是试点项目的良好条件，因为它们具有很大的成本节约潜力。此外，这些条件对供应商造成的财务风险比其他常见条件要小，因此将它们包括在内将使参与该计划对供应商更具吸引力。我们还发现，较长的发作时间获得了较高的成本和再入院率，同时几乎没有增加财务风险。我们建议医疗保险试点计划测试替代设计功能，以帮助促进整个卫生系统的支付创新。
In the National Pilot Program on Payment Bundling, a subset of Medicare providers will receive a single payment for an episode of acute care in a hospital, followed by postacute care in a skilled nursing or rehabilitation facility, the patient’s home, or other appropriate setting. This article examines the promises and pitfalls of bundled payments and addresses two important design decisions for the pilot: which conditions to include, and how long an episode should be. Our analysis of Medicare data found that hip fracture and joint replacement are good conditions to include in the pilot because they exhibit strong potential for cost savings. In addition, these conditions pose less financial risk for providers than other common ones do, so including them would make participation in the program more appealing to providers. We also found that longer episode lengths captured a higher percentage of costs and hospital readmissions while adding little financial risk. We recommend that the Medicare pilot program test alternative design features to help foster payment innovation throughout the health system.
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影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
DOI：
10.1377/hlthaff.2009.0629
发表时间：
2010-01
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Mor V;Intrator O;Feng Z;Grabowski DC
通讯作者：
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影响因子：
39.2
作者：
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通讯作者：
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影响因子：
120.7
作者：
KAHN, KL;KEELER, EB;BROOK, RH
通讯作者：
BROOK, RH
影响因子：
9
作者：
Casale, Alfred S.;Paulus, Ronald A.;Steele, Glenn D., Jr.
通讯作者：
Steele, Glenn D., Jr.