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在全州范围的商业保险公司中,医院的表现是基于事件的激励计划
Michael P Thompson1, Anne H Cain-Nielsen, Monica L Yost Karslake
1Michigan Medicine, 5331K Frankel Cardiovascular Center, 1500 E Medical Center Dr, SPC 5864, Ann Arbor, MI 48109.
这项研究评估了一项绩效支付计划.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健经济学 医疗经济学
- 提高质量 提高质量
背景情况:
- 全州范围内的商业保险计划越来越多地利用绩效支付 (P4P) 来激励医院的效率.
- 评估这些P4P计划对医院支出和行为的影响对于医疗保健政策至关重要.
研究的目的:
- 评估一项全州范围的,以商业保险为基础的,以事件为基础的P4P计划的最初两年期间的医院绩效和行为.
- 分析护理费用和P4P奖励分配的变化.
主要方法:
- 一项回顾性队列研究利用了密歇根价值协作机构的索赔数据.
- 在基线和绩效年 (2018-2019) 之间分析了价格和风险标准化的医院级治疗费用.
- 差异差异分析检查了与计划实施相关的患者一级支出变化.
主要成果:
- 医院支出在2018财年显著下降 (- 671美元),但在2019财年没有显著变化.
- 医院在2018财年平均获得6.3分,在2019财年平均获得4.5分,医院的特点差异有限.
- 得分最高的医院显示病例组合指数发生变化,总体支出减少.
结论:
- 在P4P计划的前两年,仅有有限的证据表明总体支出减少.
- 对高绩效医院的分析为改进未来P4P指标和计划设计提供了洞察力.
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