Kahn Charles N, Ault Thomas, Isenstein Howard, Potetz Lisa, Van Gelder Susan
Federation of American Hospitals, Washington, DC, USA.
Health Aff (Millwood). 2006 Jan-Feb;25(1):148-62. doi: 10.1377/hlthaff.25.1.148.
This paper examines the impact that Medicare pay-for-performance (P4P) might have upon hospital payment. It uses the initial two quarters of a national quality database to model financial gains or losses using the Premier Hospital Quality Incentive Demonstration rules, as well as the P4P approach recommended by the Medicare Payment Advisory Commission (MedPAC). Findings reveal variation among all types of hospitals and across all measures within each of the three conditions studied: heart attack, heart failure, and pneumonia. Initially, hospitals' financial gains and losses likely will be marginal using the Premier demonstration payment rules and somewhat larger under the MedPAC recommendations as modeled.
本文探讨了医疗保险按绩效付费（P4P）可能对医院支付产生的影响。它利用一个全国质量数据库的前两个季度，根据Premier医院质量激励示范规则以及医疗保险支付咨询委员会（MedPAC）推荐的P4P方法，对财务收益或损失进行建模。研究结果显示，在所研究的三种病症（心脏病发作、心力衰竭和肺炎）中，各类医院以及各项指标之间均存在差异。最初，按照Premier示范支付规则，医院的财务收益和损失可能较小，而按照MedPAC的建议进行建模时，收益和损失则会稍大一些。
