The Promise And Peril Of Accountable Care For Vulnerable Populations: A Framework For Overcoming Obstacles
The Promise And Peril Of Accountable Care For Vulnerable Populations: A Framework For Overcoming Obstacles
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DOI：
10.1377/hlthaff.2012.0490
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发表时间：
2012-08-01
期刊：
影响因子：
9.7
通讯作者：
Fisher, Elliott S.
中科院分区：
文献类型：
--
作者：
Lewis, Valerie A.;Larson, Bridget Kennedy;Fisher, Elliott S.
问责护理组织（ACO）是一种有前途的支付模式，旨在降低成本，同时提高护理质量。然而，存在着弱势群体可能无法充分融入这一新模式的风险。我们定义了两个不同的弱势群体，临床风险和社会弱势，我们讨论如何ACO可能有利于每个群体。我们提供了一个框架，用于考虑脆弱的患者和卫生系统在负责任的护理道路上面临的挑战。我们确定了可以帮助克服这些障碍的政策：支持ACO在不同环境中形成的战略，以及监测，测量和奖励接触所有患者（包括弱势群体）的提供者的表现的战略。
Accountable care organizations (ACOs) are a promising payment model aimed at reducing costs while also improving the quality of care. However, there is a risk that vulnerable populations may not be fully incorporated into this new model. We define two distinct vulnerable populations, clinically at-risk and socially disadvantaged, and we discuss how ACOs may benefit each group. We provide a framework to use in considering challenges for both vulnerable patients and health systems on the path to accountable care. We identify policies that can help overcome these obstacles: strategies that support ACO formation in diverse settings and that monitor, measure, and reward the performance of providers that reach all patients, including vulnerable populations.