Schneider Eric C, Hussey Peter S, Schnyer Christopher
Rand Health Q. 2011 Mar 1;1(1):3. eCollection 2011 Spring.
Insurers and purchasers of health care in the United States are on the verge of potentially revolutionary changes in the approaches they use to pay for health care. Recently, purchasers and insurers have been experimenting with payment approaches that include incentives to improve quality and reduce the use of unnecessary and costly services. The Patient Protection and Affordable Care Act of 2010 is likely to accelerate payment reform based on performance measurement. This article provides details of the results of a technical report that catalogues nearly 100 implemented and proposed payment reform programs, classifies each of these programs into one of 11 payment reform models, and identifies the performance measurement needs associated with each model. A synthesis of the results suggests near-term priorities for performance measure development and identifies pertinent challenges related to the use of performance measures as a basis for payment reform. The report is also intended to create a shared framework for analysis of future performance measurement opportunities. This report is intended for the many stakeholders tasked with outlining a national quality strategy in the wake of health care reform legislation.
美国医疗保健的保险公司和购买者，在其支付医疗保健费用的方式上，正处在可能发生变革的边缘。最近，购买者和保险公司一直在试验各种支付方式，其中包括旨在提高质量以及减少不必要和昂贵服务使用的激励措施。2010年的《患者保护与平价医疗法案》可能会加速基于绩效评估的支付改革。本文详细介绍了一份技术报告的结果，该报告编录了近100个已实施和提议的支付改革项目，将这些项目中的每一个归类为11种支付改革模式之一，并确定了与每种模式相关的绩效评估需求。结果的综合分析提出了绩效评估发展的近期优先事项，并确定了与将绩效评估用作支付改革基础相关的重大挑战。该报告还旨在创建一个用于分析未来绩效评估机会的共享框架。本报告面向众多在医疗保健改革立法之后负责勾勒国家质量战略的利益相关者。
