Squitieri Lee, Bozic Kevin J, Pusic Andrea L
Robert Wood Johnson Clinical Scholars Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
Value Health. 2017 Jun;20(6):834-836. doi: 10.1016/j.jval.2017.02.003. Epub 2017 Mar 22.
The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of quality and cost efficiency and ultimately receive adjusted reimbursement as per their performance. Although current performance metrics do not incorporate patient-reported outcome measures (PROMs), many wonder whether and how PROMs will eventually fit into value-based payment reform. On November 17, 2016, the second annual Patient-Reported Outcomes in Healthcare Conference brought together international stakeholders across all health care disciplines to discuss the potential role of PROs in value-based health care reform. The purpose of this article was to summarize the findings from this conference in the context of recent literature and guidelines to inform implementation of PROs in value-based payment models. Recommendations for evaluating key perspectives and measurement goals are made to facilitate appropriate use of PROMs to best benefit and amplify the voice of our patients.
美国医疗保健系统目前正经历着深刻的变革。提高患者护理质量和控制成本的压力已导致从传统的以量计费的服务收费报销模式迅速转向基于价值的支付模式。根据2015年《医疗保险准入与儿童健康保险计划再授权法案》,医疗服务提供者将根据质量和成本效益进行评估,并最终根据其表现获得调整后的报销。尽管当前的绩效指标并未纳入患者报告的结局指标(PROMs),但许多人想知道PROMs最终是否以及如何适应基于价值的支付改革。2016年11月17日,第二届年度医疗保健患者报告结局会议汇聚了所有医疗保健学科的国际利益相关者,以讨论患者报告结局指标在基于价值的医疗保健改革中的潜在作用。本文的目的是结合近期的文献和指南总结本次会议的结果,为在基于价值的支付模式中实施患者报告结局指标提供参考。文中提出了评估关键观点和测量目标的建议,以促进患者报告结局指标的合理使用,从而最大程度地造福患者并增强患者的声音。