Bailit Michael, Hughes Christine
Bailit Health Purchasing, LLC, USA.
Issue Brief (Commonw Fund). 2011 Aug;20:1-16.
Shared savings is a payment strategy that offers incentives for providers to reduce health care spending for a defined patient population by offering them a percentage of net savings realized as a result of their efforts. The concept has attracted great interest, in part fueled by Affordable Care Act provisions that create accountable care organizations and by the movement among medical home pilots to make payment methodologies more performance-based. In this issue brief, the authors interviewed payer and provider organizations and state agencies involved in shared-savings arrangements about their diverse approaches, including the populations and services covered, the assignment of providers, the use of risk adjustment, and the way savings are calculated and distributed. The authors identified issues payers and providers must resolve going forward, including determining whether savings were achieved, equipping providers with necessary tools and technical advice, agreeing upon standard performance measures, and refining the model over time.
共享节约是一种支付策略，通过向医疗服务提供者提供因他们的努力而实现的净节约的一定比例，来激励他们降低特定患者群体的医疗保健支出。这一概念引起了极大关注，部分原因是《平价医疗法案》中设立了 accountable care organizations（可问责医疗组织）的相关条款，以及医疗之家试点项目中推动支付方法更多地基于绩效的趋势。在本问题简报中，作者采访了参与共享节约安排的支付方和医疗服务提供方组织以及州机构，了解他们的不同方法，包括所涵盖的人群和服务、医疗服务提供者的分配、风险调整的使用以及节约金额的计算和分配方式。作者确定了支付方和医疗服务提供方未来必须解决的问题，包括确定是否实现了节约、为医疗服务提供者配备必要的工具和技术建议、就标准绩效指标达成一致以及随着时间的推移完善该模式。
