Jacofsky D J
The CORE Institute, 18444 N. 25th Avenue, Phoenix, AZ, USA.
Bone Joint J. 2017 Oct;99-B(10):1280-1285. doi: 10.1302/0301-620X.99B10.BJJ-2017-0355.R1.
Episodic, or bundled payments, is a concept now familiar to most in the healthcare arena, but the models are often misunderstood. Under a traditional fee-for-service model, each provider bills separately for their services which creates financial incentives to maximise volumes. Under a bundled payment, a single entity, often referred to as a convener (maybe the hospital, the physician group, or a third party) assumes the risk through a payer contract for all services provided within a defined episode of care, and receives a single (bundled) payment for all services provided for that episode. The time frame around the intervention is variable, but defined in advance, as are included and excluded costs. Timing of the actual payment in a bundle may either be before the episode occurs (prospective payment model), or after the end of the episode through a reconciliation (retrospective payment model). In either case, the defined costs over the defined time frame are borne by the convener. Cite this article: 2017;99-B:1280-5.
按病种计费，即捆绑支付，如今在医疗保健领域已为大多数人所熟知，但这种模式常常被误解。在传统的按服务收费模式下，每个供应商分别为其服务计费，这就产生了追求服务量最大化的经济激励。在捆绑支付模式下，一个单一实体，通常称为召集方（可能是医院、医师团队或第三方），通过与付款方签订的合同，承担在规定的治疗期间内提供的所有服务的风险，并就该期间内提供的所有服务获得一笔（捆绑）付款。干预前后的时间范围是可变的，但提前确定，包括和排除的成本也是如此。捆绑支付中实际付款的时间可以在治疗期间之前（预付费模式），也可以在治疗期结束后通过核对账目进行（后付费模式）。在任何一种情况下，规定时间范围内的规定成本均由召集方承担。引用本文：2017；99-B：1280-5。
