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Estado actual de los programas de adquisición por valor

Tingyin T Chee1, Andrew M Ryan1, Jason H Wasfy1

  • 1From Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC (T.T.C., W.B.B.); Department of Health Policy, University of Michigan, Ann Arbor (A.M.R.); and Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.H.W.).

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PubMed
Resumen
Este resumen es generado por máquina.

Los programas de compras basadas en el valor (VBP) ajustan los pagos al proveedor en función de las métricas de calidad. Si bien los impactos actuales de la VBP son marginales, existen oportunidades para mejorar el rendimiento y apoyar la prestación de atención orientada al valor.

Palabras clave:
costes y análisis de costesEvaluación de resultados (asistencia sanitaria)Mecanismos de reembolsocompras basadas en valor

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Área de la Ciencia:

  • Política de salud
  • Economía de la salud
  • Mejora de la calidad

Sus antecedentes:

  • El sistema de salud de EE.UU. está haciendo la transición hacia modelos de pago basados en el valor.
  • La legislación como la Ley de Cuidado de Salud Asequible y el Acceso a Medicare y la Ley de Reautorización de CHIP (MACRA) enfatizan el valor en Medicare.
  • Las aseguradoras privadas están adoptando cada vez más enfoques basados en el valor, reflejando la dirección de Medicare.

Objetivo del estudio:

  • Revisar el panorama actual de los programas de compras basadas en el valor (VBP).
  • Analizar las fortalezas, debilidades y oportunidades futuras de VBP.
  • Evaluar el papel de la VBP en el cambio más amplio hacia una atención sanitaria orientada al valor.

Principales métodos:

  • Revisión de la literatura de los programas de VBP implementados y evaluados para pacientes hospitalizados y ambulatorios.
  • Análisis de los factores políticos y de los marcos legislativos que influyen en el VBP.
  • Síntesis de la evidencia sobre los impactos y el rendimiento del programa VBP.

Principales resultados:

  • Los programas de VBP existentes han demostrado un impacto marginal en los resultados de la atención médica.
  • Las compras basadas en el valor siguen siendo un componente central de la estrategia de pago de Medicare.
  • Existen oportunidades significativas para mejorar la eficacia de la VBP a través de una mejor medición, incentivos y diseño.

Conclusiones:

  • Los programas de compra basados en el valor son parte integral de la prestación de atención médica actual y futura.
  • Las mejoras en la medición de la calidad, las estructuras de incentivos y la reducción de las disparidades son cruciales para el éxito de VBP.
  • VBP ofrece una vía para que los proveedores desarrollen infraestructura para la atención basada en el valor.