Sparer Michael S, Brown Lawrence D, Gusmano Michael K, Rowe Catherine, Gray Bradford H
Mailman School of Public Health, Columbia University, USA.
Health Aff (Millwood). 2002 Sep-Oct;21(5):284-91. doi: 10.1377/hlthaff.21.5.284.
Health plans formed by safety-net providers serve large numbers of Medicaid beneficiaries. Through a series of case studies, we examined the care management tools used by leading safety-net plans. These plans do not rely on the coercive, command-style tools of managed care. They rely instead on tools that emphasize partnership with providers: sharing data about practice patterns, using provider profiles and financial bonuses to encourage particular practice patterns, and developing disease management programs that encourage patient compliance with treatment decisions that the plans make little effort to shape. The evidence suggests that these are promising practices but that even these leaders still have a long way to go.
由安全网提供者组建的健康计划为大量医疗补助受益者提供服务。通过一系列案例研究，我们考察了领先的安全网计划所使用的护理管理工具。这些计划并不依赖管理式医疗那种强制性的、指令式工具。相反，它们依赖强调与提供者建立伙伴关系的工具：分享有关医疗模式的数据，利用提供者档案和经济奖励来鼓励特定医疗模式，以及制定疾病管理计划以鼓励患者遵守计划几乎不费力去塑造的治疗决策。有证据表明这些是有前景的做法，但即便这些领先者仍有很长的路要走。
