Lidor Anne, Telem Dana, Bower Curtis, Sinha Prashant, Orlando Rocco, Romanelli John
University of Wisconsin, Madison, WI, USA.
University of Michigan, Ann Arbor, MI, USA.
Surg Endosc. 2017 Aug;31(8):3072-3077. doi: 10.1007/s00464-017-5627-5. Epub 2017 Jun 29.
The Medicare program has transitioned to paying healthcare providers based on the quality of care delivered, not on the quantity. In May 2015, SAGES held its first ever Quality Summit. The goal of this meeting was to provide us with the information necessary to put together a strategic plan for our Society over the next 3-5 years, and to participate actively on a national level to help develop valid measures of quality of surgery. The transition to value-based medicine requires that providers are now measured and reimbursed based on the quality of services they provide rather than the quantity of patients in their care. As of 2014, quality measures must cover 3 of the 6 available National Quality domains. Physician quality reporting system measures are created via a vigorous process which is initiated by the proposal of the quality measure and subsequent validation. Commercial, non-profit, and governmental agencies have now been engaged in the measurement of hospital performance through structural measures, process measures, and increasingly with outcomes measures. This more recent focus on outcomes measures have been linked to hospital payments through the Value-Based Purchasing program. Outcomes measures of quality drive CMS' new program, MACRA, using two formats: Merit-based incentive programs and alternative payment models. But, the quality of information now available is highly variable and difficult for the average consumer to use. Quality metrics serve to guide efforts to improve performance and for consumer education. Professional organizations such as SAGES play a central role in defining the agenda for improving quality, outcomes, and safety. The mission of SAGES is to improve the quality of patient care through education, research, innovation, and leadership, principally in gastrointestinal and endoscopic surgery.
医疗保险计划已转向根据所提供护理的质量而非数量来支付医疗服务提供者费用。2015年5月，美国胃肠内镜外科医师学会（SAGES）举办了其有史以来的首次质量峰会。本次会议的目标是为我们提供必要信息，以便制定未来3至5年学会的战略计划，并在国家层面积极参与，帮助制定有效的手术质量衡量标准。向基于价值的医学转变要求现在根据医疗服务提供者提供的服务质量而非其护理患者的数量来对其进行衡量和报销。截至2014年，质量衡量标准必须涵盖6个可用国家质量领域中的3个。医师质量报告系统的衡量标准是通过一个严格的过程创建的，该过程由质量衡量标准的提议及随后的验证启动。商业、非营利和政府机构现在已通过结构指标、过程指标以及越来越多地通过结果指标来参与医院绩效的衡量。最近对结果指标的关注已通过基于价值的采购计划与医院支付挂钩。质量的结果指标通过两种形式推动了医疗保险和医疗补助服务中心（CMS）的新计划——《医疗保险和医疗补助服务中心促进互操作性法案》（MACRA）：基于绩效的激励计划和替代支付模式。但是，现在可用的信息质量差异很大，普通消费者难以使用。质量指标有助于指导提高绩效的努力和消费者教育。像SAGES这样的专业组织在确定提高质量、结果和安全性的议程方面发挥着核心作用。SAGES的使命主要是通过教育、研究、创新和领导力来提高患者护理质量，尤其是在胃肠和内镜手术方面。
