为急需的医疗补助受益人提供基于风险的合同:阿肯色州的PASS计划
Adrienne Nevola1, Michael E Morris2, Carrie Colla3
1Department of Health Policy and Management, University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR 72205, United States.
提供商主导的阿肯色州共享储蓄实体 (PASSE) 计划旨在降低行为健康 (BH) 或智力和发育障碍 (IDD) 患者的高医疗费用. 它的成功取决于改善护理协调和解决健康的社会决定因素.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 管理护理模式的管理护理模式
背景情况:
- 美国行为健康 (BH) 状况或智力和发育障碍 (IDD) 患者的高医疗保健支出需要创新的解决方案.
- 医疗补助 (Medicaid) 是一项公共医疗保险计划,覆盖低收入居民,包括那些患有BH或IDD的人,面临重大的医疗费用.
研究的目的:
- 描述由提供商领导的阿肯色州共享储蓄实体 (PASSE) 计划,一种新的托管护理模式.
- 为了将PASSE与现有的州医疗补助计划进行比较,用于类似的弱势群体.
- 评估 PASSE 计划对受益人成果的前景和潜在影响.
主要方法:
- 分析了与参与PASS计划的利益相关者进行的关键信息人采访.
- 检查在美国各地的州医疗补助计划中实施的支付模式.
- 对PASSE模型与BH/IDD人群的传统医疗补助计划进行比较分析.
主要成果:
- 关键信息提供者确定了PASS的有希望的特点:加强护理协调,服务灵活性,社区投资激励和成本和质量的综合问责制.
- 人们担心PASS功能可能无法足够改变提供商的行为,潜在的成本控制导致服务减少和不确定的质量影响.
- 该计划的有效性取决于成功改善护理协调和解决健康的社会决定因素.
结论:
- PASSE计划代表了对高需要的医疗补助人口的管理护理的重大转变.
- 虽然有希望的特征存在,但该计划在改善BH/IDD弱势群体的结果方面取得的最终成功是不确定的.
- 有效的实施取决于强大的护理协调和致力于解决健康的社会决定因素的承诺.
更多相关视频
07:41Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
07:31Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
相关概念视频
Healthcare Agencies II
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources,...
Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
Standards of Care I
Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
