Leaver William B
UnityPoint Health, Des Moines, USA.
Front Health Serv Manage. 2013 Summer;29(4):17-27.
Traditional fee-for-service medicine has put physicians on an unsustainable treadmill of volume that escalates healthcare costs regardless of the quality of care they provide. This article shares the experience of UnityPoint Health (formerly Iowa Health System) in designing and implementing patient-centered, physician-led, coordinated care as a building block for transforming the delivery system. Keys to the effort's success include aligning physicians, hospitals, and home care delivery in terms of organizational goals and having the ability to gather, analyze, and share data to manage population health. On April 16, 2013, Iowa Health System became UnityPoint Health, dedicated to transforming the delivery of care through a coordinated system that offers regional, organized systems of care in most of our markets in Iowa and Illinois. These capabilities allowed the system to enter into value-based accountable care organization contracts that cover more than 220,000 lives. The transition ultimately will lead to population health-driven approaches in which compensation will be based on the management of specific populations or chronic diseases over a specified period. As increased value from care coordination becomes clear, the external environment will demand this better system, and patients will expect it.
传统的按服务收费医疗模式让医生陷入了一种难以持续的工作量循环，这使得医疗成本不断攀升，而不论他们所提供的医疗服务质量如何。本文分享了联合健康集团（前身为爱荷华医疗系统）在设计和实施以患者为中心、由医生主导的协调护理方面的经验，这是转变医疗服务提供体系的一个基石。这项工作取得成功的关键包括在组织目标方面使医生、医院和家庭护理服务保持一致，以及具备收集、分析和共享数据以管理人群健康的能力。2013年4月16日，爱荷华医疗系统更名为联合健康集团，致力于通过一个协调体系来转变医疗服务的提供方式，该体系在爱荷华州和伊利诺伊州的大部分市场提供区域性、有组织的医疗服务体系。这些能力使该系统能够签订基于价值的责任医疗组织合同，覆盖超过22万人。这种转变最终将带来以人群健康为导向的方法，即薪酬将基于在特定时期内对特定人群或慢性病的管理情况。随着护理协调所带来的价值增加变得明显，外部环境将需要这种更好的系统，患者也会期待它。
