患者报告的基于结果的绩效指标在替代支付模式:当前使用,实施障碍和成功的原则
Cameron J Gettel1, Lisa G Suter2, Kyle Bagshaw3
1Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven CT, USA.
患者报告的基于结果的绩效指标 (PRO-PMs) 面临实施障碍,但在14个CMS计划中使用. 优先考虑临床相关性,样本大小,性能范围,公平性和风险调整是PRO-PM成功的关键.
科学领域:
- 医疗保健质量测量 医疗保健质量测量
- 医疗保健服务研究 医疗服务研究
背景情况:
- 患者报告的基于结果的绩效指标 (PRO-PMs) 允许使用聚合调查数据进行实体级绩效评估.
- 关于PRO-PM实施障碍,当前的利用和成功原则,存在文献上的差距.
研究的目的:
- 确定PRO-PMs的实施障碍.
- 评估目前在医疗保险和医疗补助服务中心 (CMS) 计划中的PRO-PMs的使用情况.
- 概述成功开发和实施PRO-PM的关键原则,特别是在替代支付模式 (APM) 中.
主要方法:
- 专家对PRO-PM的关键原则及其在APM中的作用进行了审查.
- 对CMS措施库存工具 (2023年5月) 的系统审查,以确定积极的PRO-PM使用情况.
- 综合发现,以提出PRO-PM成功的优先原则.
主要成果:
- 确定了五个主要的实施障碍:工具开发,响应率,提供者负担,公平性问题和结果归因.
- 在14个CMS程序中发现了54个积极使用PRO-PM的实例,涉及46个独特的PRO-PM.
- 对于PRO-PM成功的五个基本原则包括临床突出性,适当的样本大小,有意义的绩效范围,股权重点和适当的风险调整.
结论:
- 解决已识别的障碍和优先考虑关键原则对于PRO-PM的开发和实施至关重要.
- 将PRO-PM与支付计划联系起来需要仔细考虑提供商和利益相关者的参与.
- 成功的PRO-PM集成可以提高医疗保健质量测量和问责制.
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