医疗保险共享储蓄计划:成本较高的可负责任的护理组织更有可能实现储蓄
Stephanie Berkson1, Sarah Davis1, Zaher Karp1
1School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, USA.
International journal of healthcare management
|October 3, 2023
概括
在医疗保险中负责的护理组织 (ACO)
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健政策 医疗保健政策
- 卫生经济学 卫生经济学
背景情况:
- 医疗保险共享储蓄计划 (MSSP) 是改善医疗保健质量和降低成本的关键举措.
- 2014年第一年业绩数据显示,MSSP参与者的财务和质量结果各不相同.
- 了解推动ACO节约的因素对于计划的成功和可持续性至关重要.
研究的目的:
- 确定与在医疗保险共享储蓄计划 (MSSP) 中产生储蓄相关的关键特征.
- 分析基础支出,质量评分和ACO的财务业绩之间的关系.
- 为有关ACO计划设计和激励措施的政策提供信息.
主要方法:
- 观察性研究利用了来自220个参与ACO的2013年财务和质量数据.
- 基于ACO特征进行统计分析,以评估节省成本的可能性.
- 节约成本的ACO与没有节约成本的ACO之间的质量评分比较.
主要成果:
- 基线支出较高的ACO更有可能产生节约.
- 在节省成本的ACO和没有节省成本的ACO之间,没有观察到平均质量得分的显著差异.
- 在招生前使用率较低似乎使ACO在节省成本方面处于不利地位.
结论:
- 当前的MSSP设计可能不成比例地奖励ACO以更高的初始支出,可能不利于高效,低成本的组织.
- 这些发现对吸引和留住高效的ACO在MSSP中的政策产生了重大影响.
- 该计划激励废物减少和质量改善的能力可能会受到这些观察到的特征的影响.
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