使护理成为首要:医疗保险对以价值为基础的初级保健的最新尝试
Wasan Kumar1, Eli Y Adashi2, Bob Kocher3
1Stanford University, School of Medicine, Stanford, CA 94305, United States.
Health affairs scholar
|May 17, 2024
概括
医疗保险和医疗补助创新中心推出了Making Care Primary (MCP) 模式,以改革初级保健. 这一基于价值的支付计划可能面临挑战,并影响市场整合.
科学领域:
- 卫生政策 卫生政策
- 医疗保健管理的管理
- 以价值为基础的护理
背景情况:
- 美国医疗保险和医疗补助创新中心 (CMMI) 在2023年6月8日推出了Making Care Primary (MCP) 模式.
- MCP是一个为期十年的倡议,旨在将初级保健转变为基于价值的支付系统.
- 它是一个多支付者合作伙伴关系,为初级保健机构提供自愿的,风险调整的支付结构.
研究的目的:
- 分析Making Care Primary (MCP) 模型的结构和潜在影响.
- 评估MCP在改变初级保健提供和支付系统中的作用.
- 确定MCP倡议的潜在挑战和意外后果.
主要方法:
- 该MCP模型有三个轨道,提供不同程度的财务支持和风险.
- 它包括每位受益人未来的支付和对基础设施发展的激励.
- 医生必须满足质量结果,社会需求查和慢性护理管理的标准.
主要成果:
- 该MCP模型为基于价值的护理基础设施提供了财政支持.
- 它为初级保健机构提供前性支付和风险调整模型.
- 医生参与要求遵守质量和护理管理标准.
结论:
- 该MCP模型是重塑初级保健支付和提供的一项重大努力.
- 与之前的CMS计划类似的潜在挑战可能会影响MCP的成功.
- 该模型可能会导致意想不到的后果,包括对市场整合的影响.
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