付款人-提供者合资企业对医疗保健价值的影响
Laura F Garabedian1,2, J Frank Wharam1,2,3, Joseph P Newhouse4,5,6,7
1Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Health services research
|November 5, 2024
概括
一个新的付款人-提供商合资企业 (JV) 没有影响医疗保健价值. 尽管有领导人领导人.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 以价值为基础的护理
- 付款人-提供商合作.
背景情况:
- 付款人-提供商合资企业 (JVs) 越来越多地被探索以提高医疗保健价值.
- 本研究评估了新罕布什尔州 (NH) 的一个特定的合资企业,该企业结合了基于价值的支付和护理管理.
- 了解这些合资企业对医疗保健利用,质量和支出的影响至关重要.
研究的目的:
- 评估新型付款人-提供者合资企业 (JV) 对医疗保健价值的影响.
- 评估对医疗保健利用,质量和支出的影响.
- 了解付款人和提供者集团领导人与合资企业的经验.
主要方法:
- 一个采用准实验的纵向差异设计的混合方法研究.
- 利用商业保险人口 (2013-2019) 的行政和索赔数据.
- 包括对护理管理计划采用情况的分析和与领导者的半结构面试.
主要成果:
- 联合企业没有对整体医疗利用,质量或支出产生持续影响.
- 最初的调查结果显示,药品支出增加,糖尿病药物治疗日数增加.
- 在护理管理计划中的参与率低 (15%);领导者认为成本降低和质量提高.
结论:
- 调查结果为未来的付款者提供者联合企业提供了洞察力.
- 强调使用有效的控制组来评估JV和基于价值的支付模式至关重要.
- 表明这家合资企业的感知和实际结果之间存在分歧.
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