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医疗保险 ACCESS 模式的承诺和不确定性
Aditya Narayan1, Bob Kocher2,3
1Stanford University School of Medicine, Stanford, CA 94305, United States.
Health affairs scholar
|February 16, 2026
概括
美国医疗保险和医疗补助服务中心 (CMS) 推出了用于慢性疾病管理的新ACCESS支付模式,专注于临床改进而不是服务提供. 它的成功取决于有关支付,质量测量和护理协调的详细实施.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 慢性疾病管理 慢性疾病管理
背景情况:
- 医疗保险的现有支付系统往往鼓励分立的医疗保健接触,而不是持续的,基于结果的护理.
- 越来越需要支付模式来支持技术支持的慢性疾病管理和纵向患者护理.
研究的目的:
- 分析医疗保险和医疗补助服务中心 (CMS) 新的急性和慢性护理病情 (ACCESS) 支付模式的结构和影响.
- 识别关键问题和潜在的挑战,与实施的 ACCESS 模式的慢性疾病管理.
主要方法:
- 对拟议的 ACCESS 支付模式结构的分析.
- 审查ACCCESS模型对患者护理和提供者补偿的目标和潜在影响.
- 确定需要进一步澄清的领域,包括支付水平,质量指标,风险调整和护理协调.
主要成果:
- 该 ACCESS 模型代表了转向与临床改善相关的循环,特定条件支付的转变.
- 它旨在增加对技术支持的纵向护理的报销,并加强患者的选择.
- 关于支付具体情况,质量测量,风险调整和与传统医疗保健服务的整合,仍然存在重大问题.
结论:
- ACCESS模型为慢性疾病管理支付提供了一种新的方法,有可能改善纵向护理.
- 它对加强初级保健和改善患者结果的最终影响取决于详细的政策实施和解决悬而未决的问题.
- 需要进一步评估,以了解 ACCESS 模型将如何影响技术支持服务和传统医疗保健系统之间的护理协调.
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