Value-Based Provider Payment Initiatives Combining Global Payments With Explicit Quality Incentives: A Systematic Review.
Value-Based Provider Payment Initiatives Combining Global Payments With Explicit Quality Incentives: A Systematic Review.
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DOI：
10.1177/1077558719856775
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Eijkenaar F
中科院分区：
文献类型：
--
作者：
Cattel D;Eijkenaar F
追求基于价值的医疗保健的一个基本要素是提供者支付改革。本文旨在识别和分析支付举措，其中包括基于价值的支付改革的具体表现形式，这些改革有望在广义上促进价值：（a）全球基本支付与（b）明确的质量激励相结合。我们对文献进行了系统回顾，咨询了四个科学书目数据库、参考文献列表、互联网和专家。我们纳入并比较了 111 篇文章/文档中描述的 18 项举措，涉及关键设计功能及其对价值的影响。这些举措在两个支付组件的运营和相关设计功能方面是异构的。这些举措之间的主要共同点是高度重视初级保健、使用“虚拟”支出目标以及风险调整和其他风险缓解措施的应用。评估的举措通常显示出良好的结果，即支出增长较低，但质量相同或有所提高。
An essential element in the pursuit of value-based health care is provider payment reform. This article aims to identify and analyze payment initiatives comprising a specific manifestation of value-based payment reform that can be expected to contribute to value in a broad sense: (a) global base payments combined with (b) explicit quality incentives. We conducted a systematic review of the literature, consulting four scientific bibliographic databases, reference lists, the Internet, and experts. We included and compared 18 initiatives described in 111 articles/documents on key design features and impact on value. The initiatives are heterogeneous regarding the operationalization of the two payment components and associated design features. Main commonalities between initiatives are a strong emphasis on primary care, the use of “virtual” spending targets, and the application of risk adjustment and other risk-mitigating measures. Evaluated initiatives generally show promising results in terms of lower spending growth with equal or improved quality.
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