全连续过程中的问责制：亚急性护理提供者在问责制医疗组织中的参与情况。
Accountability across the Continuum: The Participation of Postacute Care Providers in Accountable Care Organizations.
作者信息
Colla Carrie H, Lewis Valerie A, Bergquist Savannah L, Shortell Stephen M
机构信息
The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Lebanon, NH.
Department of Health Care Policy, Harvard Medical School, Boston, MA.
出版信息
Health Serv Res. 2016 Aug;51(4):1595-611. doi: 10.1111/1475-6773.12442. Epub 2016 Jan 22.
Abstract
OBJECTIVE
To examine the extent to which accountable care organizations (ACOs) formally incorporate postacute care providers.
DATA SOURCES
The National Survey of ACOs (N = 269, response rate 66 percent).
STUDY DESIGN
We report statistics on ACOs' formal inclusion of postacute care providers and the organizational characteristics and clinical capabilities of ACOs that have postacute care.
PRINCIPAL FINDINGS
Half of ACOs formally include at least one postacute service, with inclusion at higher rates in ACOs with commercial (64 percent) and Medicaid contracts (70 percent) compared to ACOs with Medicare contracts only (45 percent). ACOs that have a formal relationship with a postacute provider are more likely to have advanced transition management, end of life planning, readmission prevention, and care management capabilities.
CONCLUSIONS
Many ACOs have not formally engaged postacute care, which may leave room to improve service integration and care management.
摘要
目的
探讨 accountable care organizations（ACO）正式纳入急性后期护理服务提供者的程度。
数据来源
ACO 全国调查（N = 269，回复率 66%）。
研究设计
我们报告有关 ACO 正式纳入急性后期护理服务提供者的统计数据，以及有急性后期护理服务的 ACO 的组织特征和临床能力。
主要发现
一半的 ACO 正式纳入了至少一项急性后期护理服务，与仅签订医疗保险合同的 ACO（45%）相比，签订商业保险合同（64%）和医疗补助合同（70%）的 ACO 纳入比例更高。与急性后期护理服务提供者建立正式关系的 ACO 更有可能具备先进的过渡管理、临终规划、再入院预防和护理管理能力。
结论
许多 ACO 尚未正式参与急性后期护理，这可能为改善服务整合和护理管理留出空间。
相似文献
1
Accountability across the Continuum: The Participation of Postacute Care Providers in Accountable Care Organizations.全连续过程中的问责制：亚急性护理提供者在问责制医疗组织中的参与情况。
Health Serv Res. 2016 Aug;51(4):1595-611. doi: 10.1111/1475-6773.12442. Epub 2016 Jan 22.
2
End-of-Life Care Planning in Accountable Care Organizations: Associations with Organizational Characteristics and Capabilities.在问责制医疗组织中进行临终关怀规划：与组织特征和能力的关联。
Health Serv Res. 2018 Jun;53(3):1662-1681. doi: 10.1111/1475-6773.12720. Epub 2017 May 30.
3
Medicaid Accountable Care Organizations in Four States: Implementation and Early Impacts.四个州的医疗补助管理式医疗组织：实施与早期影响。
Milbank Q. 2019 Jun;97(2):583-619. doi: 10.1111/1468-0009.12386. Epub 2019 Apr 7.
4
The Hidden Roles That Management Partners Play In Accountable Care Organizations.管理合伙人在问责制医疗组织中扮演的隐性角色。
Health Aff (Millwood). 2018 Feb;37(2):292-298. doi: 10.1377/hlthaff.2017.1025.
5
Clinical coordination in accountable care organizations: A qualitative study.责任医疗组织中的临床协调：一项定性研究。
Health Care Manage Rev. 2019 Apr/Jun;44(2):127-136. doi: 10.1097/HMR.0000000000000141.
6
Why Do Accountable Care Organizations Leave The Medicare Shared Savings Program?为什么问责制医疗保健组织会退出联邦医疗保险共享储蓄计划？
Health Aff (Millwood). 2019 May;38(5):794-803. doi: 10.1377/hlthaff.2018.05097.
7
How Do Accountable Care Organizations Deliver Preventive Care Services? A Mixed-Methods Study.问责制医疗组织如何提供预防保健服务？一项混合方法研究。
J Gen Intern Med. 2019 Nov;34(11):2451-2459. doi: 10.1007/s11606-019-05271-5. Epub 2019 Aug 20.
8
Preventive Care Quality of Medicare Accountable Care Organizations: Associations of Organizational Characteristics With Performance.医疗保险责任医疗组织的预防保健质量：组织特征与绩效的关联
Med Care. 2016 Mar;54(3):326-35. doi: 10.1097/MLR.0000000000000477.
9
Assessing Provider Partnerships For Accountable Care Organizations.评估负责医疗组织的供应商合作伙伴关系。
Manag Care. 2018 Mar;27(3):40-49.
10
Medicare Accountable Care Organizations of Diverse Structures Achieve Comparable Quality and Cost Performance.不同结构的医疗保险责任制医疗组织实现了可比的质量和成本绩效。
Health Serv Res. 2018 Aug;53(4):2303-2323. doi: 10.1111/1475-6773.12829. Epub 2018 Jan 31.
引用本文的文献
1
How Benchmark Changes Affect Participation in Accountable Care Organizations: Prospects for Voluntary Payment Models.基准变化如何影响对 accountable care organizations 的参与：自愿支付模式的前景。
Am J Health Econ. 2025 Winter;11(1):38-62. doi: 10.1086/726748. Epub 2024 Dec 17.
2
Association of Skilled Nursing Facility Ownership by Health Care Networks With Utilization and Spending.医疗保健网络拥有的熟练护理设施与利用和支出的关联。
JAMA Netw Open. 2023 Feb 1;6(2):e230140. doi: 10.1001/jamanetworkopen.2023.0140.
3
Association of Patient Outcomes With Bundled Payments Among Hospitalized Patients Attributed to Accountable Care Organizations.责任医疗组织住院患者的捆绑支付与患者结局的关联。
JAMA Health Forum. 2021 Aug 20;2(8):e212131. doi: 10.1001/jamahealthforum.2021.2131. eCollection 2021 Aug.
4
The association of vertically integrated care with health care use and outcomes.纵向整合医疗保健与医疗保健的使用和结果的关联。
Health Serv Res. 2021 Oct;56(5):817-827. doi: 10.1111/1475-6773.13642. Epub 2021 Mar 17.
5
Savings or Selection? Initial Spending Reductions in the Medicare Shared Savings Program and Considerations for Reform.储蓄还是选择？医疗保险共享储蓄计划中的初始支出削减及其改革考虑。
Milbank Q. 2020 Sep;98(3):847-907. doi: 10.1111/1468-0009.12468. Epub 2020 Jul 22.
6
Transitional Care Outcomes in Veterans Receiving Post-Acute Care in a Skilled Nursing Facility.退伍军人在熟练护理设施中接受康复治疗后的过渡护理结果。
J Am Geriatr Soc. 2019 Sep;67(9):1820-1826. doi: 10.1111/jgs.15971. Epub 2019 May 10.
7
Changes in Use of Postacute Care Associated With Accountable Care Organizations in Hip Fracture, Stroke, and Pneumonia Hospitalized Cohorts.与 accountable care organizations 相关的髋部骨折、中风和肺炎住院患者队列的 postacute care 使用变化。
Med Care. 2019 Jun;57(6):444-452. doi: 10.1097/MLR.0000000000001121.
8
Quality measurement and nursing homes: measuring what matters.质量评估与疗养院：衡量重要之事
BMJ Qual Saf. 2019 Jul;28(7):520-523. doi: 10.1136/bmjqs-2019-009447. Epub 2019 Apr 17.
9
Achieving Integrated Care for Older People: What Kind of Ship? Comment on "Achieving Integrated Care for Older People: Shuffling the Deckchairs or Making the System Watertight for the Future?".实现老年人整合照护：何种船只？评“实现老年人整合照护：调整甲板上的椅子，或为未来做好系统防水？”。
Int J Health Policy Manag. 2018 Sep 1;7(9):870-873. doi: 10.15171/ijhpm.2018.44.
10
The Effects of Medicare Accountable Organizations on Inpatient Mortality Rates.医疗保险责任组织对住院死亡率的影响。
Inquiry. 2018 Jan-Dec;55:46958018800092. doi: 10.1177/0046958018800092.
本文引用的文献
1
A taxonomy of accountable care organizations for policy and practice.用于政策与实践的责任医疗组织分类法。
Health Serv Res. 2014 Dec;49(6):1883-99. doi: 10.1111/1475-6773.12234. Epub 2014 Sep 23.
2
Cancer spending and accountable care organizations: Evidence from the Physician Group Practice Demonstration.癌症支出与责任医疗组织：来自医师团体执业示范项目的证据。
Healthc (Amst). 2013 Dec 1;1(3-4):100-107. doi: 10.1016/j.hjdsi.2013.05.005.
3
Patient referrals: a linchpin for increasing the value of care.患者转诊：提升医疗价值的关键因素。
JAMA. 2014 Aug 13;312(6):597-8. doi: 10.1001/jama.2014.7878.
4
First national survey of ACOs finds that physicians are playing strong leadership and ownership roles.首个全国性的 ACO 调查发现，医师在其中发挥着强有力的领导和所有权作用。
Health Aff (Millwood). 2014 Jun;33(6):964-71. doi: 10.1377/hlthaff.2013.1463.
5
Post-acute care--the next frontier for controlling Medicare spending.急性后期护理——控制医疗保险支出的下一个前沿领域。
N Engl J Med. 2014 Feb 20;370(8):692-4. doi: 10.1056/NEJMp1315607.
6
Post-acute care reform--beyond the ACA.急性后期护理改革——超越《平价医疗法案》
N Engl J Med. 2014 Feb 20;370(8):689-91. doi: 10.1056/NEJMp1315350.
7
Accountable Care Organizations in the United States: market and demographic factors associated with formation.美国的问责制医疗组织：与组建相关的市场和人口统计学因素。
Health Serv Res. 2013 Dec;48(6 Pt 1):1840-58. doi: 10.1111/1475-6773.12102. Epub 2013 Oct 1.
8
Can all cause readmission policy improve quality or lower expenditures? A historical perspective on current initiatives.所有导致再次入院的政策都能提高质量或降低支出吗？对当前举措的历史视角。
Health Econ Policy Law. 2014 Apr;9(2):193-213. doi: 10.1017/S1744133113000340. Epub 2013 Aug 30.
9
Effects of integrated delivery system on cost and quality.综合交付系统对成本和质量的影响。
Am J Manag Care. 2013 May 1;19(5):e175-84.
10
Large increases in spending on postacute care in Medicare point to the potential for cost savings in these settings.医疗保险中对急性后期护理的支出大幅增加，表明这些治疗环境中存在节省成本的潜力。
Health Aff (Millwood). 2013 May;32(5):864-72. doi: 10.1377/hlthaff.2012.1262.
Zotero 插件