Consolidation Among Cardiologists Across U.S. Practices Over Time.
Consolidation Among Cardiologists Across U.S. Practices Over Time.
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DOI：
10.1016/j.jacc.2020.04.081
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发表时间：
2020-08-04
影响因子：
24
通讯作者：
Joynt Maddox KE
中科院分区：
文献类型：
--
作者：
Figueroa JF;Lam MB;Orav EJ;Joynt Maddox KE
最近的医疗改革努力和医疗保健市场的变化更广泛地为心脏病专家和其他医疗保健提供者创造了一个新的财务现实（1）。虽然许多最初的基于价值的支付模式集中在住院设置，注意力现在转移到门诊护理。所有向医疗保险开门诊服务账单的医生，在没有某些豁免的情况下，现在都必须参加医疗保险和医疗补助服务中心（CMS）基于绩效的奖励支付系统，该系统评估临床医生的质量，成本，电子健康记录的使用以及参与实践改进活动。另一种选择是临床医生加入替代支付模式，如负责任的护理组织或捆绑支付计划，这些计划通常根据护理质量和成本奖励奖金和罚款。在私人支付方方面，保险公司继续巩固其市场力量，这可能会影响心脏病专家谈判合同和报销的能力以及这样做的行政复杂性。
Recent health reform efforts and changes in health care markets more broadly are creating a new financial reality for cardiologists and other health care providers (1). Although many of the initial value-based payment models focused on the inpatient setting, attention is now shifting to outpatient care. All physicians billing Medicare for ambulatory services, absent certain exemptions, are now required to participate in the Centers for Medicare and Medicaid Services (CMS) Merit-Based Incentive Payment System, which evaluates clinicians on quality, costs, use of electronic health records, and participation in practice improvement activities. Another option is for clinicians to join alternative payment models, such as accountable care organizations or bundled payment programs, which typically award bonuses and penalties based on quality and costs of care. On the private payer side, insurers continue to consolidate in efforts to increase their market power, which may influence the ability of cardiologists to negotiate contracts and reimbursements and the administrative complexity of doing so.
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作者：
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