马里兰州初级保健实践在通过一种新的基于价值的支付方式来解决社会需求方面的经验
Emily Gruber1, Rachel Grisham1, Hannah Arem2,3
1Maryland Department of Health, Office of Advanced Primary Care, Baltimore, Maryland, USA.
Health services research
|October 22, 2025
概括
心脏支付模式成功支持患者的健康相关的社会需求,尽管存在针对性和管理方面的挑战. 未来的基于价值的支付应该完善患者的身份识别,以调整社会风险.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 基于价值的护理模式
- 健康的社会决定因素
背景情况:
- 基于价值的支付机制越来越多地被探索,以解决与健康相关的社会需求.
- 马里兰州初级保健计划 (MDPCP) 实施了HEART支付,以支持患者的社会和医疗需求.
- 了解提供者的看法对于完善这些支付模式至关重要.
研究的目的:
- 评估 HEART 支付所感知的成功和挑战.
- 探索类似基于价值的支付机制的机会,以解决与健康相关的社会需求.
- 从参与MDPCP的初级保健实践中收集反.
主要方法:
- 对MDPCP中初级保健实践的看法进行分析.
- 从2023年2月到3月,通过调查 (112个回复) 和重点小组 (7组) 收集数据.
- 定量分析包括描述性统计和回归;定性分析涉及对关键主题的编码.
主要成果:
- 61.3%的受访者认为HEART支付具有高价值.
- 成功的关键:直接支持患者的社会需求 (运输,家庭补救,孤独).
- 发现的挑战:需要精确的患者资格定位和行政负担.
结论:
- 心脏支付是初级保健实践解决社会需求的一个有希望的模式.
- 未来的基于价值的模型应该考虑精细的方法来识别具有高社会需求的患者.
- 替代数据点或直接提供者识别可以改善患者向.
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