Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, Mercy Health Hauenstein Neuroscience Center, Grand Rapids, MI, USA.
Lancet Neurol. 2016 Apr;15(4):444-50. doi: 10.1016/S1474-4422(16)00020-X.
Health care in the USA is undergoing a drastic transformation under the Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act is driving major health-care policy changes by connecting payment for traditional health-care services to value-based care initiatives and emphasising population health and innovative mechanisms to deliver care. Under the Patient Protection and Affordable Care Act, neurological practice will need to adapt and transform. Therefore, neurological policy should consider employing a new framework for neurological residency training, developing interdisciplinary team approaches to neurological subspecialty care, and strengthening the primary care-neurological specialty care interface to avoid redundancies and other medical waste. Additionally, neurological policy will need to support a more robust review of diagnostic and care pathway use to reduce avoidable expenditures, and test and implement bundled payments for key neurological diagnoses. In view of an anticipated 19% shortage of US neurologists in the next 10 years, development of new neurological policy under the Patient Protection and Affordable Care Act is paramount.
在美国，《患者保护与平价医疗法案》正在推动医疗保健发生重大变革。《患者保护与平价医疗法案》通过将传统医疗服务的支付与基于价值的医疗保健举措挂钩，并强调人群健康和创新的护理提供机制，正在推动主要的医疗保健政策变革。根据《患者保护与平价医疗法案》，神经科实践将需要适应和转变。因此，神经科政策应该考虑采用新的框架来进行神经科住院医师培训，制定跨学科团队方法来提供神经科亚专科护理，并加强初级保健与神经科专科护理的界面，以避免重复和其他医疗浪费。此外，神经科政策需要支持对诊断和护理途径使用进行更全面的审查，以减少不必要的支出，并测试和实施针对主要神经科诊断的捆绑式支付。鉴于未来 10 年内美国神经科医生预计短缺 19%，根据《患者保护与平价医疗法案》制定新的神经科政策至关重要。
