为患有医疗复杂性的儿童开发可持续的护理服务支付模式
Timothy E Corden1,2, Tera Bartelt2, Sarah Johaningsmeir1
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Hospital pediatrics
|December 18, 2023
概括
为患有医疗复杂性 (CMC) 的儿童开发可持续的支付模式,改善了护理协调和利益相关者价值. 这种创新方法解决了儿科复杂护理计划的财务挑战.
科学领域:
- 儿科医疗保健 儿科医疗保健
- 卫生经济学 卫生经济学
- 护理协调 护理协调
背景情况:
- 患有医疗复杂性 (CMC) 的儿童代表了医疗保健成本的重大负担.
- 现有的服务费模式阻碍了复杂的护理计划的财务可持续性.
- 综合护理旨在改善CMC的结果和家庭功能.
研究的目的:
- 描述CMC的可持续复杂护理支付模式的发展.
- 评估这种新型支付模式为利益相关者创造的价值.
- 概述了复杂护理中成功的付款人-临床医生合作的关键要素.
主要方法:
- 威斯康星州两个复杂护理计划及其州医疗补助支付人之间的合作.
- 利用了医疗保险和医疗补助服务中心的医疗保健创新奖.
- 采用时间研究方法来衡量提供服务的护理成本.
主要成果:
- 为复杂的护理服务建立了可持续的支付模式.
- 证明了CMC,家庭和医疗保健系统的价值.
- 促进了基于相互理解的支付人-临床医生关系的加强.
结论:
- 可持续的支付模式对于儿科复杂护理计划的可行性至关重要.
- 付款人-临床医生合作伙伴关系和可靠的成本测量是创新的医疗保健融资的关键.
- 该模型提供了一个可扩展的解决方案,用于改善CMC的护理服务和财务绩效.
相关概念视频
Methods Of Healthcare Delivery System
3.3K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.3K
Methods of Documentation VI: Case Management Model
574
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
574
Introduction To Health Care Delivery System
2.8K
The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
2.8K
Issues And Trends In Healthcare Delivery System
5.6K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.6K
Secondary Healthcare System
1.5K
Secondary healthcare is offered by a specialist, generally in hospitals or clinics for patients referred by primary healthcare providers. It occurs when a person has an illness or injury that requires specific medical care. Secondary care is often referred to as acute care. Secondary care can range from uncomplicated care to repair a minor laceration or treat a strep throat infection to more complicated emergent care, such as treating a head injury sustained in an automobile accident. Whatever...
1.5K
Specialized Care Centers and Settings-II
728
Rural Health Centers
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...
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...
728


