Mark McClellan is chair of the Accountable Care Forum at the World Innovation Summit for Health (WISH), Qatar Foundation, and a senior fellow and director of the Health Care Innovation and Value Initiative at the Brookings Institution, in Washington, D.C.
James Kent is a partner and managing director in the Boston Consulting Group's London office, in the United Kingdom.
Health Aff (Millwood). 2014 Sep;33(9):1507-15. doi: 10.1377/hlthaff.2014.0373.
Accountable care--a way to align health care payments with patient-focused reform goals--is currently being pursued in the United States, but its principles are also being applied in many other countries. In this article we review experiences with such reforms to offer a globally applicable definition of an accountable care system and propose a conceptual framework for characterizing and assessing accountable care reforms. The framework consists of five components: population, outcomes, metrics and learning, payments and incentives, and coordinated delivery. We describe how the framework applies to accountable care reforms that are already being implemented in Spain and Singapore. We also describe how it can be used to map progress through increasingly sophisticated levels of reforms. We recommend that policy makers pursuing accountable care reforms emphasize the following steps: highlight population health and wellness instead of just treating illness; pay for outcomes instead of activities; create a more favorable environment for collaboration and coordinated care; and promote interoperable data systems.
责任医疗保健模式——一种使医疗保健支付与以患者为中心的改革目标保持一致的模式——目前正在美国推行,但该模式的原则也正在许多其他国家应用。本文我们将回顾这些改革的经验,提供一个适用于全球的责任医疗保健系统定义,并提出一个用于描述和评估责任医疗保健改革的概念框架。该框架由五个部分组成:人群、结果、指标和学习、支付和激励以及协调交付。我们描述了该框架如何适用于已经在西班牙和新加坡实施的责任医疗保健改革。我们还描述了如何通过越来越复杂的改革水平来使用它来衡量进展。我们建议推行责任医疗保健改革的政策制定者们强调以下步骤:强调人群的健康和幸福,而不仅仅是治疗疾病;根据结果而不是活动付费;为合作和协调护理创造更有利的环境;并促进互操作性数据系统。