Dis Manag Advis. 2002 Sep;8(9):133-9, 129.
Providers have long complained that traditional managed care systems fail to the meet the needs of highly complex cases; the typical time constraints, reimbursement rates, and utilization management patterns are simply inadequate, in many cases, to keep such persons stabilized and out of the hospital. But now there is proof that there may, indeed, be a better way to manage these cases so that patients will be more satisfied, costs will be reduced, and outcomes improved. Sound too good to be true? Check out the "plan within a plan" concept implemented at Massachusetts-based Neighborhood Health Plan.
长期以来，医疗服务提供者一直抱怨传统的管理式医疗系统无法满足高度复杂病例的需求；在许多情况下，典型的时间限制、报销率和使用管理模式根本不足以让这些患者保持病情稳定并避免住院。但现在有证据表明，确实可能有一种更好的方式来管理这些病例，从而使患者更满意、成本降低且治疗结果得到改善。听起来好得难以置信？看看马萨诸塞州的邻里健康计划所实施的“计划中之计划”概念。
