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Mental Health Care Under New Payment Strategies

新支付策略下的精神卫生保健

基本信息

批准号：
9237825
负责人：
ELLEN R. MEARA
金额：
$ 74.49万
依托单位：
DARTMOUTH COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-26 至 2020-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9237825
关键词：
Address Adoption Affect Benchmarking Bipolar Disorder Caring Characteristics Communities Complex Contracts County Data Data Collection Effectiveness Evidence based treatment Goals Health Health Care Costs Health Personnel Health Services Healthcare Hospitalization Individual Insurance Carriers Knowledge Learning Life Link Measures Medicaid Medicare Medicare claim Medicare/Medicaid Mental Health Mental disorders National Institute of Mental Health New York Organizational Innovation Outcome Outcome Measure Participant Patient Care Patient-Focused Outcomes Patients Performance Population Primary Health Care Process Provider Publishing Quality of Care Reporting Research Risk Schizoaffective Disorders Schizophrenia Specific qualifier value Strategic Planning Surveys System Testing Treatment outcome Vulnerable Populations base behavioral health beneficiary care delivery design experience financial incentive health care delivery improved innovation meetings novel payment physical conditioning population based population health programs safety net severe mental illness

项目摘要

PROJECT SUMMARY The quality of care delivered to patients with serious mental illness (SMI) lags well behind the potential to treat these patients, given an array of efficacious evidence-based treatments available. Fragmentation of care and rigid, poorly aligned payment approaches contribute to inadequate physical and mental health care for patients with SMI. New contracting and payment strategies aim to increase the quality and value of care for patients with SMI using financial incentives and explicit quality of care benchmarks. These emerging strategies hold promise for increasing the efficiency and effectiveness of care for patients with SMI, one of the objectives in the 2015 NIMH Strategic Plan for Research. Despite increasing adoption of new payment strategies by public insurers, which insure a disproportionate share of patients with SMI, scant evidence describes whether and how these changes are linked to quality of care and outcomes for this vulnerable group, and even less is known about contract or organization features that may improve quality of care for patients with SMI. New health care payment and delivery contracts have many goals: encouraging coordination of care, promoting delivery of care in the most appropriate setting, improving population health, and containing health care costs. In this proposed research, using the start date of novel payment contracts, we will 1) examine how emerging contracts between providers and insurers address health care for patients with SMI;; 2) estimate how the quality of care and outcomes for patients with SMI change with payment contract designs and organizational strategies;; and 3) estimate how population health measures are associated with contract designs and organizational strategies targeting physical and mental health care for people with mental illness. To complete the research, we will develop and field a mental health-focused wave of an ongoing survey of health care provider organizations (Aim 1). We will link these new survey data on contract designs and mental health- specific organizational strategies to patient-level administrative claims data (Aims 2 and 3) to better understand the implications of emerging contracts for quality of care and population health outcomes for people with SMI. The proposed research will help to tailor emerging payment contracts and organizational strategies to meet the needs of populations with mental illness.

项目摘要为严重精神疾病（SMI）患者提供的护理质量远远落后于治疗的潜力这些患者，给予一系列有效的循证治疗。僵化、不协调的支付方式导致患者的身心健康护理不足新的合同和支付策略旨在提高患者护理的质量和价值。 SMI使用财务激励和明确的护理质量基准。这些新兴战略承诺提高SMI患者护理的效率和有效性，这是 2015年NIMH研究战略计划。尽管公众越来越多地采用新的支付策略，保险公司为比例不成比例的SMI患者提供保险，很少有证据说明是否这些变化如何与这一弱势群体的护理质量和结果联系在一起，了解可以提高SMI患者护理质量的合同或组织特征。新卫生保健支付和交付合同有许多目标：鼓励协调保健，促进在最适当的环境中提供保健，改善人口健康，控制保健费用。在这项拟议的研究中，使用新的支付合同的开始日期，我们将1）研究如何出现供应商和保险公司之间的合同解决了SMI患者的医疗保健问题; 102）估计 SMI患者的护理质量和结局随支付合同设计和组织战略; 3）估计人口健康措施如何与合同设计相关联，针对精神疾病患者的身心健康护理的组织战略。要完成这项研究，我们将开发和领域的一个正在进行的医疗保健调查的心理健康--重点波供应商组织（目标1）。我们将把这些关于合同设计和心理健康的新调查数据联系起来- 具体的组织战略，以病人的行政索赔数据（目标2和3），以更好地了解新合同对重度精神障碍患者的护理质量和人群健康结果的影响。拟议的研究将有助于调整新兴的支付合同和组织战略，以满足精神疾病患者的需求。