How The Center For Medicare And Medicaid Innovation Should Test Accountable Care Organizations
How The Center For Medicare And Medicaid Innovation Should Test Accountable Care Organizations
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DOI：
10.1377/hlthaff.2010.0453
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发表时间：
2010-07-01
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：
Shortell, Stephen M.;Casalino, Lawrence P.;Fisher, Elliott S.
《患者保护和平价医疗法案》在医疗保险和医疗补助服务中心（CMS）的主持下，于2012年1月前为责任医疗组织（ACO）建立了一个国家自愿计划。该法案还在CMS中创建了医疗保险和医疗补助创新中心。我们建议，中央管理系统应容许助理文书主任根据其具体情况，例如是否完全整合系统，灵活地将其分级。此外，我们建议CMS承担ACO条款的责任，并制定一个有序的系统，学习如何创建和维持ACO。关键步骤将包括制定具体的业绩目标，发展促进变革的技能和工具，建立衡量和问责机制，以及支持领导能力的发展。
The Patient Protection and Affordable Care Act establishes a national voluntary program for accountable care organizations (ACOs) by January 2012 under the auspices of the Centers for Medicare and Medicaid Services (CMS). The act also creates a Center for Medicare and Medicaid Innovation in the CMS. We propose that the CMS allow flexibility and tiers in ACOs based on their specific circumstances, such as the degree to which they are or are not fully integrated systems. Further, we propose that the CMS assume responsibility for ACO provisions and develop an ordered system for learning how to create and sustain ACOs. Key steps would include setting specific performance goals, developing skills and tools that facilitate change, establishing measurement and accountability mechanisms, and supporting leadership development.