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通过替代支付模式投资儿童健康:来自北卡罗来纳州儿童综合护理的教训
Greeshma James1, Elizabeth Kasper2, Charlene A Wong2,3,4
1Duke Margolis Center for Health Policy, Durham, NC, USA.
Medical care research and review : MCRR
|December 29, 2023
概括
实施儿科价值支付改革需要解决投资回报率的挑战,并调整儿童健康的激励措施. 北卡罗来纳州的北卡罗来纳州.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 儿科健康政策 儿科健康政策
- 基于价值的医疗保健
背景情况:
- 基于价值的儿科支付改革面临挑战,原因是儿童特定措施的回报率有限,以及医疗保健以外的收益.
- 联邦资助的儿童综合照顾 (InCK) 模式要求为医疗补助计划儿童提供以儿童为中心的替代支付模式 (APM).
研究的目的:
- 评估北卡罗来纳州儿童综合护理 (NC InCK) 儿科APM的设计过程.
- 通过采访专家,制定未来以儿童为中心的基于价值的支付改革战略.
主要方法:
- 质量研究涉及NC Medicaid管理护理组织,NC Medicaid和精算师专家的采访.
- 专注于评估NC InCK APM设计过程,并确定改革的关键原则.
主要成果:
- 确定的关键原则包括与付款人的优先事项保持一致,解决数据不确定性对投资的影响,并将短期ROI与儿童整体健康相协调.
- 诸如授权和财政激励等国家杆对于促进新型儿科措施的实施至关重要.
结论:
- 成功的以儿童为中心的基于价值的支付改革需要采取战略方法,考虑付款人的准备,数据基础设施和长期投资前景.
- 未来的改革应该利用国家特定的机制来鼓励采用全面的,以儿童为中心的支付模式.
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