Silow-Carroll Sharon, Edwards Jennifer N, Rodin Diana
Health Management Associates, USA.
Issue Brief (Commonw Fund). 2013 Mar;10:1-9.
Colorado, Minnesota, and Vermont are pioneering innovative health care payment and delivery system reforms. While the states are pursuing different models, all three are working to align incentives between health care payers and providers to better coordinate care, enhance prevention and disease management, reduce avoidable utilization and total costs, and improve health outcomes. Colorado and Minnesota are implementing accountable care models for Medicaid beneficiaries, while Vermont is pursuing multipayer approaches and moving toward a unified health care budget. This synthesis describes the common drivers of reform across the states, lessons learned, and opportunities for federal administrators to help shape, support, and promote expansion of promising state initiatives. It also synthesizes strategies and lessons for other states considering payment and delivery reforms. The accompanying case studies describe the states' efforts in greater detail.
科罗拉多州、明尼苏达州和佛蒙特州正在率先开展创新的医疗保健支付和服务体系改革。虽然这几个州采用的模式各不相同，但三者都致力于调整医疗保健支付方与服务提供方之间的激励机制，以便更好地协调医疗服务、加强预防和疾病管理、减少不必要的医疗服务使用和总体成本，并改善健康状况。科罗拉多州和明尼苏达州正在为医疗补助受益人实施责任医疗模式，而佛蒙特州则采用多支付方方式，并朝着统一的医疗保健预算迈进。本综述阐述了各州改革的共同驱动因素、经验教训以及联邦管理人员在帮助塑造、支持和推动有前景的州级举措扩展方面的机遇。它还总结了其他考虑进行支付和服务改革的州的策略和经验教训。随附的案例研究更详细地描述了各州的努力。
