21世纪的医疗保险:了解促进改进的计划
David M Kalainov1, Cynthia Barnard, Jessica Walradt
1From the Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Medical Director of Orthopedic Surgery, Northwestern Memorial Hospital, Chicago, IL (Kalainov), Department of Medicine, Northwestern University Feinberg School of Medicine, Vice President, Quality, Northwestern Memorial HealthCare, Chicago, IL (Barnard), Director, Performance Based Reimbursement and Value-Based Care, Northwestern Medicine, Chicago, IL (Walradt).
医疗保险正在从服务费转向基于价值的支付,以改善医疗保健质量和控制成本. 这一概述有助于整形外科医生和医疗保健领导者了解医疗保险计划,以获得更好的进展.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 整形外科手术 整形外科手术
背景情况:
- 医疗保险是美国近20%人口的主要支付人.
- 目前的服务费模式在控制不断上升的医疗保健成本方面面临挑战.
- 越来越需要向基于价值的护理支付模式过渡.
研究的目的:
- 提供对医疗保险计划的全面概述.
- 为骨科外科医生,临床医生,管理人员,政策制定者和商业领袖增强理解.
- 激发改善医疗保险计划的创新想法.
主要方法:
- 这是一本入门书,综合了医疗保险的信息.
- 它涵盖了对于理解该计划至关重要的相互关联的主题.
- 没有收集新的数据;这是一个信息概述.
主要成果:
- 转向以价值为基础的护理是由提高质量和控制成本的需求驱动的.
- 了解医疗保险的结构和支付模式对于利益相关者来说至关重要.
- 该手册旨在为专业人士提供战略决策的知识.
结论:
- 更深入地了解医疗保险可以促进医疗保健提供和支付方面的进步.
- 利益相关者可以利用这些知识来导航和改进医疗保险系统.
- 这本入门书是优化医疗保险对医疗保健影响的基础资源.
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