MedicalManagement of AdvocateHealth Care and AdvocatePhysician Partners, Mt Prospect, Illinois, USA.
Health Aff (Millwood). 2011 Jan;30(1):161-72. doi: 10.1377/hlthaff.2010.0824. Epub 2010 Dec 16.
The Affordable Care Act encourages the formation of accountable care organizations as a new part of Medicare. Pending forthcoming federal regulations, though, it is unclear precisely how these ACOs will be structured. Although large integrated care systems that directly employ physicians may be most likely to evolve into ACOs, few such integrated systems exist in the United States. This paper demonstrates how Advocate Physician Partners in Illinois could serve as a model for a new kind of accountable care organization, by demonstrating how to organize physicians into partnerships with hospitals to improve care, cut costs, and be held accountable for the results. The partnership has signed its first commercial ACO contract effective January 1, 2011, with the largest insurer in Illinois, Blue Cross Blue Shield. Other commercial contracts are expected to follow. In a health care system still dominated by small, independent physician practices, this may constitute a more viable way to push the broader health care system toward accountable care.
平价医疗法案鼓励将问责制医疗组织作为医疗保险的一个新组成部分。尽管即将出台联邦法规，但这些 ACO 将如何构建尚不清楚。虽然直接雇用医生的大型综合医疗系统最有可能演变成 ACO，但美国这样的综合系统很少。本文通过展示伊利诺伊州的倡导者医师合伙人（Advocate Physician Partners）如何将医生组织成与医院的合作伙伴关系，以改善护理、降低成本并对结果负责，展示了一种新的问责制医疗组织模式。该合作伙伴关系已于 2011 年 1 月 1 日与伊利诺伊州最大的保险公司蓝十字蓝盾（Blue Cross Blue Shield）签署了首份商业 ACO 合同。预计还会有其他商业合同跟进。在仍然以小型独立医生实践为主导的医疗体系中，这可能是推动更广泛的医疗体系向问责制医疗发展的一种更可行的方式。
