在医疗保险的熟练护理设施价值基础采购计划中,金融激励的规模
Robert E Burke1,2,3,4, Franya Hutchins2,5, Jonathan Heintz6
1Division of Hospital Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
JAMA network open
|September 24, 2025
概括
熟练护理机构基于价值的采购 (SNF VBP) 计划提供了小规模的财务激励,平均占净营业收入的0.15%. 这种变化可能阻碍了SNF VBP.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健政策 医疗保健政策
- 以价值为基础的护理
背景情况:
- 熟练护理设施价值基础采购 (SNF VBP) 计划利用金融激励来减少医院再入院.
- 最初的评估表明成功程度有限,这促使人们对激励措施的大小和分布的作用进行调查.
研究的目的:
- 量化SNF VBP计划在最初三年 (2019-2021) 的财政激励措施的规模和范围.
- 评估这些激励措施对熟练护理机构的财务业绩和重新录取减少努力的影响.
主要方法:
- 一项回顾性队列研究分析了参与SNF的医疗保险退款,SNF VBP金融激励比例和净营业收入.
- 数据涵盖了2019年至2021年的符合条件的SNF住宿和收费医疗保险受益者.
主要成果:
- 报销调整的中位数为-10,336美元,占SNF中位数净营业收入的0.15%.
- 金融激励措施表现出明显的年比年变化,只有22.3%的SNF在三年内保持在相同的绩效四分位数.
结论:
- 在SNF VBP计划中的财政激励措施是温和和高度可变的,这可能会限制其在推动减少医院再入院的投资方面的有效性.
- 这些发现表明,需要重新评估激励结构,以实现基于价值的采购计划的期望结果.
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