Hilsenrath Peter, Eakin Cynthia, Fischer Katrina
University of the Pacific, Stockton, CA, USA
University of the Pacific, Stockton, CA, USA.
Inquiry. 2015 Apr 10;52. doi: 10.1177/0046958015574981. Print 2015.
Health care reform is directed toward improving access and quality while containing costs. An essential part of this is improvement of pricing models to more accurately reflect the costs of providing care. Transparent prices that reflect costs are necessary to signal information to consumers and producers. This information is central in a consumer-driven marketplace. The rapid increase in high deductible insurance and other forms of cost sharing incentivizes the search for price information. The organizational ability to measure costs across a cycle of care is an integral component of creating value, and will play a greater role as reimbursements transition to episode-based care, value-based purchasing, and accountable care organization models. This article discusses use of activity-based costing (ABC) to better measure the cost of health care. It describes examples of ABC in health care organizations and discusses impediments to adoption in the United States including cultural and institutional barriers.
医疗保健改革旨在在控制成本的同时提高可及性和质量。其中的一个重要部分是改进定价模式，以更准确地反映提供医疗服务的成本。反映成本的透明价格对于向消费者和生产者传递信息至关重要。这些信息在以消费者为导向的市场中至关重要。高免赔额保险和其他形式的成本分摊的迅速增加促使人们寻求价格信息。在一个护理周期内衡量成本的组织能力是创造价值的一个不可或缺的组成部分，并且随着报销方式向基于诊疗过程的护理、基于价值的采购和 accountable care organization 模式转变，将发挥更大的作用。本文讨论了使用作业成本法（ABC）来更好地衡量医疗保健成本。它描述了医疗保健组织中作业成本法的实例，并讨论了在美国采用该方法的障碍，包括文化和制度障碍。
