Center for Health Management Research, University of Washington, Seattle, WA, USA.
Health Aff (Millwood). 2013 May;32(5):998-1006. doi: 10.1377/hlthaff.2012.1124.
To help contain health care spending and improve the quality of care, practitioners and policy makers are trying to move away from fee-for-service toward value-based payment, which links providers' reimbursement to the value, rather than the volume, of services delivered. With funding from the Robert Wood Johnson Foundation, eight grantees across the country are designing and implementing value-based payment reform projects. For example, in Salem, Oregon, the Physicians Choice Foundation is testing "Program Oriented Payments," which include incentives for providers who follow a condition-specific program of care designed to meet goals set jointly by patient and provider. In this article we describe the funding rationale and the specific objectives, strategies, progress, and early stages of implementation of the eight projects. We also share some early lessons and identify prerequisites for success, such as ensuring that providers have broad and timely access to data so they can meet patients' needs in cost-effective ways.
为了帮助控制医疗保健支出并提高医疗质量，从业者和政策制定者正试图从按服务收费转向基于价值的支付方式，这种方式将提供者的报销与所提供服务的价值而非数量联系起来。在罗伯特·伍德·约翰逊基金会的资助下，全国有八个受赠方正在设计和实施基于价值的支付改革项目。例如，在俄勒冈州塞勒姆，医生选择基金会正在测试“以项目为导向的支付”，其中包括对遵循特定疾病护理方案的提供者的激励措施，这些方案旨在实现患者和提供者共同设定的目标。在本文中，我们描述了这八个项目的资金理由以及具体目标、策略、进展和早期实施情况。我们还分享了一些早期经验教训，并确定了成功的先决条件，例如确保提供者能够广泛而及时地获得数据，以便他们能够以具有成本效益的方式满足患者的需求。
