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风险之路:结构化方法的关键要素
Mark E Schario1,2, Peter J Pronovost3,4, Patrick Runnels5,6
1UH Quality Care Network & UH Accountable Care Organization, University Hospitals Health System, Cleveland, Ohio, USA.
基于价值的护理要求提供者管理质量和成本. 该框架概述了组织成功导航医疗保健下行风险安排的关键结构要素.
科学领域:
- 医疗保健管理的管理
- 卫生经济学 卫生经济学
- 基于价值的护理模式
背景情况:
- 基于价值的护理 (VBC) 安排是负责任的护理的核心.
- 大多数现有合同只涉及上行风险,奖励提供者表现良好.
- 付款人正在转向下行风险,回顾过去的全球资本化模式带来的挑战.
研究的目的:
- 提出一个框架,以成功的基于价值的安排.
- 为承担下行风险的提供者组织确定必要的结构元素.
- 为导航VBC合同提供一个实用的模型.
主要方法:
- 专注于大学医院负责护理组织开发的框架.
- 应用方法来识别关键结构组件.
- 对管理财务和质量结果的基本要素的分析.
主要成果:
- 确定了VBC成功的关键要素:质量绩效和报告,风险调整,利用管理,护理管理,网络完整性,技术和合同.
- 证明了这些元素的适用性,即使没有下行风险.
- 为基于价值的护理采用提供了一个战略路线图.
结论:
- 成功地假设VBC的下行风险需要强大的结构元素.
- 这份框架为提供者组织提供了一份实用指南.
- 这些组件的战略规划和实施对于VBC的成功至关重要.
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