National Academy for State Health Policy, Portland, ME, USA.
Health Aff (Millwood). 2011 Jul;30(7):1325-34. doi: 10.1377/hlthaff.2011.0170.
This article describes patient-centered medical home initiatives that seventeen states have launched. These initiatives use national recognition or state-based qualification standards along with incentive payments to address soaring costs and lagging health outcomes in state Medicaid programs. Even though these initiatives are in their infancy, early results are encouraging. Modest increases in payment to physicians, aligned with quality improvement standards, have not only resulted in promising trends for costs and quality, but have also greatly improved access to care. Several state programs have already demonstrated declines in per capita costs for patients enrolled in Medicaid; increased participation of physicians in caring for Medicaid patients; and high patient and provider satisfaction. These early results give states good reason to continue developing patient-centered medical homes as part of their Medicaid programs. This article provides a closer look at these innovative models, to inform public and private reform efforts.
本文介绍了 17 个州推出的以患者为中心的医疗之家计划。这些计划采用国家认可或基于州的资格标准以及激励性支付，以解决州医疗补助计划中飙升的成本和滞后的健康结果。尽管这些计划还处于起步阶段，但早期结果令人鼓舞。对医生的支付适度增加，与质量改进标准相一致，不仅为成本和质量带来了有希望的趋势，而且还极大地改善了医疗服务的可及性。一些州的计划已经显示出参加医疗补助计划的患者的人均成本下降；更多的医生参与照顾医疗补助患者；以及患者和提供者的满意度很高。这些早期结果为各州提供了充分的理由，继续将以患者为中心的医疗之家作为其医疗补助计划的一部分进行开发。本文更详细地介绍了这些创新模式，以为公共和私营部门的改革努力提供信息。
