Siddique Shazia Mehmood, Mehta Shivan J
Division of Gastroenterology, Perelman School of Medicine, 3400 Civic Center Boulevard-7th Floor Gastroenterology, Philadelphia, PA 19104, USA.
Division of Gastroenterology, Perelman School of Medicine, 3400 Civic Center Boulevard-14th Floor Innovation Center, Philadelphia, PA 19104, USA.
Anesthesiol Clin. 2017 Dec;35(4):715-724. doi: 10.1016/j.anclin.2017.08.005.
To control costs and improve quality, changes in health care delivery and financing have emerged, resulting in shifting of financial risk to providers for the quality and cost of care, including emergence of accountable care organizations and bundled payment models. This article discusses health care financing and delivery models in the context of procedures and surgeries that happen outside of the operating room. It describes the history of health insurance, trends in ambulatory surgery centers, and new payment models that have emerged from the Affordable Care Act and the Medicare Access and Children's Health Insurance Program Reauthorization Act.
为了控制成本并提高质量,医疗服务提供和融资方面出现了变革,导致医疗服务的质量和成本方面的财务风险向提供者转移,包括 accountable care organizations(可问责医疗组织)和捆绑支付模式的出现。本文在手术室以外进行的手术和操作的背景下讨论医疗保健融资和提供模式。它描述了医疗保险的历史、门诊手术中心的趋势,以及源自《平价医疗法案》和《医疗保险准入与儿童健康保险计划再授权法案》的新支付模式。