学术支付模式:护理和覆盖范围
Erika D Harness1, Zachary N Goldberg1,2, Yash B Shah1
1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Population health management
|March 5, 2024
概括
在学术医学中,整合护理和保险的学术支付方式正在出现. 这种模式,通常是以医疗服务提供者为主,并利用医疗保险优势,显示了推进基于价值的护理 (VBC) 的潜力.
科学领域:
- 医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
- 学术医学 学术医学
背景情况:
- 美国医疗保健系统正在寻求改善,以实现五重目标.
- 改革付款人-提供者关系对于推进基于价值的护理 (VBC) 至关重要.
- 通过垂直整合整合护理和覆盖的Payvider模型提供了一个潜在的解决方案.
研究的目的:
- 识别和描述采用Payvider模型的学术医疗机构,称为学术Payviders.
- 了解美国学术支付系统的流行和结构特征.
主要方法:
- 评估所有美国医学院协会 (AAMC) 成员的全方位医学院.
- 纳入标准:通过付款人伙伴关系或所有权提供医疗护理和保险覆盖.
- 识别符合这些标准的系统.
主要成果:
- 从171个AAMC会员项目中确定了25个学术支付系统.
- 大多数系统是在2009年 (n=20) 之后创建的,并使用了供应商主导模式 (n=17).
- 医疗保险优势是提供的主要计划 (n=23).
结论:
- 学术支付机构的兴起可能受到"平价医疗法案"的影响,医疗保健整合,并专注于健康的社会决定因素 (SDOH).
- 这一运动可以推动学术医学向更大的VBC采用.
- 潜在的进步包括医疗教育,住院资源管理和行政领导方面的创新.
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