Farley D E
Health Policy and Analysis, HSS, Inc., Bethesda, Maryland, USA.
Healthc Financ Manage. 2000 Jun;54(6):54-8.
Because risk management is costly, many health plans and providers practice risk avoidance by transferring risk to other entities. Risk-bearing healthcare organizations can improve their return on assets, but to do so they need complete information about patients' health status and the availability of effective medical treatment. To improve their return on assets, providers can use risk-management strategies such as growth, designing incentives to encourage providers and health plans to reduce or eliminate unnecessary variations in resource use, and improving information about the reasons for variations in resource use and controlling those variations when possible. Providers need data to analyze why variations in resource use occur and to evaluate the efficiency of their resource use.
由于风险管理成本高昂，许多健康保险计划和医疗服务提供者通过将风险转移给其他实体来规避风险。承担风险的医疗保健组织可以提高其资产回报率，但要做到这一点，他们需要有关患者健康状况和有效医疗服务可及性的完整信息。为了提高资产回报率，医疗服务提供者可以采用风险管理策略，如业务增长、设计激励措施以鼓励医疗服务提供者和健康保险计划减少或消除资源使用中的不必要差异，以及改善有关资源使用差异原因的信息并在可能的情况下控制这些差异。医疗服务提供者需要数据来分析资源使用差异产生的原因，并评估其资源使用的效率。
