Lowell Kristina Hanson, Bertko John
Engelberg Center for Health Care Reform,The Brookings Institution, Washington, District of Columbia 20036, USA.
J Ambul Care Manage. 2010 Jan-Mar;33(1):81-8. doi: 10.1097/JAC.0b013e3181c9fb12.
The Accountable Care Organization (ACO) model has received significant attention among policymakers and leaders in the healthcare community in the context of the ongoing debate over health reform, not only because of the unsustainable path on which the country now finds itself but also because it directly focuses on what must be a key goal of the healthcare system: higher value. The model offers a promising approach for achieving this goal. This article provides an overview of the ACO model and its role in the current policy context, highlights the key elements that will be common to all ACOs, and provides details of several challenges that may arise throughout the implementation process, including a host of technical, legal, and operational challenges. These challenges range from issues such as the organizational form and management of the ACO to analytic challenges such as the calculation of spending benchmarks and the selection of quality measures.
在当前关于医疗改革的持续辩论背景下， accountable care organization（ACO）模式受到了医疗保健界政策制定者和领导者的极大关注。这不仅是因为该国目前所处的不可持续道路，还因为它直接聚焦于医疗保健系统的一个关键目标：更高的价值。该模式为实现这一目标提供了一种有前景的方法。本文概述了ACO模式及其在当前政策背景下的作用，强调了所有ACO共有的关键要素，并详细阐述了在实施过程中可能出现的若干挑战，包括一系列技术、法律和运营挑战。这些挑战涵盖了从ACO的组织形式和管理等问题到诸如支出基准计算和质量指标选择等分析挑战。
