医疗保健股权调整和医院在基于价值的购买计划中的表现
Michael Liu1,2, Sahil Sandhu2, Karen E Joynt Maddox3,4,5
1Section of Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
医疗保险在医院价值基础采购 (HVBP) 计划中的新医疗公平调整 (HEA) 将促进安全网和为黑人患者服务的医院的支付. 这一政策旨在使基于价值的护理更加公平.
科学领域:
- 卫生政策
- 医疗经济学
- 医疗公平
背景情况:
- 医疗保险的基于价值的医院采购 (HVBP) 计划鼓励医院提高护理质量.
- 2026财年将实施新的健康公平调整 (HEA),以支持服务于双重医疗保险和医疗补助患者的医院.
- 医疗保健对医院绩效和支付分配的影响在很大程度上是未知的.
研究的目的:
- 估计由于HEA导致的医院绩效的潜在变化.
- 确定与HEA政策相关的医院特征.
- 分析不同类型医院的支付再分配情况.
主要方法:
- 在HVBP计划中对2676家医院进行横截面分析 (2021财年).
- 将公共计划数据与双重资格受益人的医疗保险申请联系起来.
- 计算HEA积分和HVBP支付调整以模拟政策影响.
主要成果:
- 102家医院从奖金转为罚款,119家医院在HEA模拟后从罚款转为奖金.
- 平均HVBP支付调整降低了HEA后的4,534美元,个人医院的差异很大.
- 安全网络医院和那些服务于黑人患者的医院获得了最大的净积极支付调整.
- 农村医院和南部或医疗补助扩张州的医院更有可能看到支付增加.
结论:
- 预计HVBP计划中的HEA将大大重新分类医院绩效并重新分配支付.
- 预计黑人患者服务的医院将受益最多.
- 在医疗保险的基于价值的支付计划中,HEA是提高公平性的重要策略.
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