Horizon's patient-centered medical home program shows practices need much more than payment changes to transform.
Horizon's patient-centered medical home program shows practices need much more than payment changes to transform.
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Horizon 以患者为中心的医疗之家计划表明，要实现转变，实践需要的不仅仅是支付方式的改变。
DOI：
10.1377/hlthaff.2012.0392
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发表时间：
2012
期刊：
影响因子：
9.7
通讯作者：
Elizabeth Rubin
中科院分区：
文献类型：
--
作者：
U. Patel;Carl Rathjen;Elizabeth Rubin
飞涨的费用和参差不齐的病人护理质量对美国医疗保健系统构成了挑战。一些医疗保险公司正在探索以患者为中心的医疗之家，通过增加初级保健提供者对护理协调和结果的问责制，以此来改变激励机制和改造卫生保健提供系统。新泽西州历史最悠久、规模最大的医疗保险公司Horizon Healthcare Services， Inc.开发了医疗家庭计划，其中包括财务激励和基本支持工具。我们在实施和评估各种方法方面的经验表明，医疗之家需要由坚定的初级保健领导支持的密集和有针对性的患者护理协调，以及包括每月护理协调费和基于结果的支付在内的新支付结构。我们的经验还表明，要提高护理质量和降低成本，需要大量的非金钱支持，例如针对人口护理协调员的教育计划、提供将诊所转变为医疗之家的有效方法的医疗之家指南，以及有用的数据共享。
Skyrocketing costs and the uneven quality of patient care challenge the US health care system. Some health insurance companies are exploring patient-centered medical homes as a way to change incentives and transform the health care delivery system by increasing primary care providers' accountability for care coordination and outcomes. Horizon Healthcare Services, Inc., New Jersey's oldest and largest health insurance company, developed medical home programs that include financial incentives with essential support tools. Our experience in implementing and evaluating various approaches indicates that medical homes require intensive and targeted patient care coordination supported by committed primary care leadership, as well as new payment structures that include a monthly care coordination fee and outcome-based payments. Our experience also indicates that considerable nonmonetary support-such as an education program for population care coordinators, a medical home guide that offers effective ways to transform a practice into a medical home, and useful data sharing-are needed to improve the quality of care and reduce costs.