组织因素与ACOs中初级保健提供者的变化有关
Mariétou H Ouayogodé1, Xiaodan Liang, Sancia K Ferguson
1Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, 610 Walnut St, Madison, WI 53726.
The American journal of managed care
|April 14, 2025
概括
拥有更多初级保健提供者的负责护理组织 (ACO) 与医生领导和基于绩效的报酬有关. 了解这些劳动力动态是ACO成功和临床医生保留的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
- 卫生经济学 卫生经济学
背景情况:
- 负责任的护理组织 (ACO) 旨在通过协调护理来提高医疗保健质量和降低成本.
- 了解影响ACO提供商员工组成的因素对于其运营成功和可持续性至关重要.
- 之前的研究还没有完全阐明ACO组织结构与其提供商组合之间的关系.
研究的目的:
- 评估问责护理组织 (ACO) 的组织结构与其提供者劳动力组成之间的关联.
- 量化ACO结构,合同类型和提供商组合之间的关系,以告知招聘和保留策略.
- 识别导致医疗保健工作人员变化的因素.
主要方法:
- 这是一项横截面研究,利用了来自全国问责护理组织调查 (2017-2018) 的409个ACO的数据.
- 采用多变量线性回归模型来检查ACO提供商的劳动力组成,合同类型,结构和财务风险之间的关系.
- 分析包括对医疗保险共享储蓄计划参与者的市场环境的评估.
主要成果:
- 提供商的劳动力组成因ACO合同付款人而异.
- 单一公共支付人合同 (医疗补助或医疗保险) 的较小ACO的初级保健提供者的百分比比较高,而商业或多个支付人合同的较大ACO则较高.
- 在ACO中,更高比例的初级保健提供者与医生领导,上行财务风险和基于绩效的医生薪酬有关.
结论:
- ACO,特别是较大的 ACO,应考虑基于人口的支付和修订的补偿策略,以使提供者保持一致,提高质量和成本效益.
- 实施有效的供应商参与和薪酬模式可以减轻供应商的营业额,并提高ACO的可持续性.
- 这些发现为优化ACO组织结构提供了见解,以支持提供者保留和计划成功.
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