Fostering Accountable Health Care: Moving Forward In Medicare
Fostering Accountable Health Care: Moving Forward In Medicare
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DOI：
10.1377/hlthaff.28.2.w219
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发表时间：
2009-03-01
期刊：
影响因子：
9.7
通讯作者：
Skinner, Jonathan S.
中科院分区：
文献类型：
--
作者：
Fisher, Elliott S.;McClellan, Mark B.;Skinner, Jonathan S.
要取得成功，医疗改革必须在提高质量的同时减缓支出增长。我们提出了一种新方法，通过绩效衡量和“共享储蓄”支付改革，促进地方组织对质量和成本的问责，从而帮助实现更综合、更高效的医疗服务。这种办法是实际可行的：提供者是自愿的，以目前的转诊模式为基础，不需要改变福利或锁定受益人，即使在总费用受到限制的情况下，提供者也有可能获得持续的收入。我们模拟了潜在的支出影响，并表明显著的医疗保险储蓄是可能的。[卫生事务28，no. 1][2] (2009): w219-w231(2009年1月27日在线发布；10.1377/hlthaff.28.2.w219)]
To succeed, health care reform must slow spending growth while improving quality. We propose a new approach to help achieve more integrated and efficient care by fostering local organizational accountability for quality and costs through performance measurement and "shared savings" payment reform. The approach is practical and feasible: it is voluntary for providers, builds on current referral patterns, requires no change in benefits or lock-in for beneficiaries, and offers the possibility of sustained provider incomes even as total costs are constrained. We simulate the potential expenditure impact and show that significant Medicare savings are possible. [Health Affairs 28, no. 2 (2009): w219-w231 (published online 27 January 2009; 10.1377/hlthaff.28.2.w219)]