Pain Management Center of Paducah, Paducah, Kentucky 42003, USA.
J Neurointerv Surg. 2012 Nov;4(6):468-72. doi: 10.1136/neurintsurg-2011-010141. Epub 2011 Oct 11.
The Independent Payment Advisory Board (IPAB) is a powerful component of the Affordable Care Act, with the authority to issue recommendations to reduce the growth in Medicare spending and to provide recommendations to Congress for fast-track implementation. The IPAB works by recommending policies to Congress to help Medicare provide better care at a lower cost, including ideas on coordinating care, getting rid of waste in the system, providing incentives for best practices and prioritizing primary care. Congress then has the power to accept or reject these recommendations. However, Congress faces extreme limitations either to enact policies that achieve equivalent savings or to let the Secretary of Health and Human Services (HHS) follow the IPAB's recommendations. The IPAB statute sets target growth rates for Medicare spending. The applicable percentage for maximum savings appears to be 0.5% for 2015, 1% for 2016, 1.25% for 2017 and 1.5% for 2018 and later. The IPAB Medicare proposal process involves mandatory recommendations and advisory recommendations with multiple reporting requirements. We believe neurointerventionalists, as highly specialized physicians reliant on expensive technology, should be aware of the IPAB and its impact on the practice of medicine.
独立支付咨询委员会（Independent Payment Advisory Board，简称 IPAB）是《平价医疗法案》（Affordable Care Act）的一个重要组成部分，有权就降低医疗保险支出增长提出建议，并向国会提供快速实施的建议。IPAB 通过向国会提出建议来帮助医疗保险以更低的成本提供更好的护理，包括协调护理、消除系统中的浪费、为最佳实践提供激励以及优先考虑初级保健的想法。国会随后有权接受或拒绝这些建议。然而，国会在制定能够实现同等储蓄的政策方面面临极端限制，或者让卫生与公众服务部部长（Secretary of Health and Human Services，简称 HHS）遵循 IPAB 的建议。IPAB 法规为医疗保险支出设定了目标增长率。适用于最大储蓄的百分比似乎是 2015 年的 0.5%，2016 年的 1%，2017 年的 1.25%，2018 年及以后的 1.5%。IPAB 医疗保险提案流程涉及强制性建议和咨询建议，并有多项报告要求。我们认为，神经介入医师作为高度专业化的医生，依赖昂贵的技术，应该了解 IPAB 及其对医学实践的影响。
