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1
Market Evaluation: Finances, Bundled Payments, and Accountable Care Organizations.市场评估:财务、捆绑支付与 accountable care 组织。 (注:“accountable care”可直译为“可问责医疗”,这里意译为“责任医疗”,具体翻译可根据上下文和专业习惯调整,这里为了保留英文表述方便你理解,未进行意译替换。)
Anesthesiol Clin. 2017 Dec;35(4):715-724. doi: 10.1016/j.anclin.2017.08.005.
2
Comparing mandated health care reforms: the Affordable Care Act, accountable care organizations, and the Medicare ESRD program.比较强制医疗改革:平价医疗法案、责任医疗组织和医疗保险终末期肾病计划。
Clin J Am Soc Nephrol. 2012 Sep;7(9):1535-43. doi: 10.2215/CJN.01220212. Epub 2012 May 24.
3
United States Health Care Reform: Progress to Date and Next Steps.美国医疗保健改革:迄今取得的进展及后续步骤。
JAMA. 2016 Aug 2;316(5):525-32. doi: 10.1001/jama.2016.9797.
4
Accountable care organizations and the allergist: challenges and opportunities.责任医疗组织与过敏科医生:挑战与机遇。
J Allergy Clin Immunol Pract. 2014 Jan-Feb;2(1):34-9. doi: 10.1016/j.jaip.2013.09.020.
5
Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and Alternative Payment Models in dermatology.21 世纪美国政策改革背景下临床皮肤科的未来思考:《平价医疗法案》和《儿童健康保险计划再授权法案》与皮肤科的替代支付模式。
J Am Acad Dermatol. 2017 Jun;76(6):1213-1217. doi: 10.1016/j.jaad.2017.01.031. Epub 2017 Mar 30.
6
Anticipating the effect of the Patient Protection and Affordable Care Act for patients with urologic cancer.预期《患者保护与平价医疗法案》对泌尿系统癌症患者的影响。
Urol Oncol. 2014 Feb;32(2):55-58. doi: 10.1016/j.urolonc.2013.10.017.
7
If accountable care organizations are the answer, who should create them?如果 accountable care organizations 是答案,那么应由谁来创建它们呢? (注:accountable care organizations 可直译为“ accountable care组织”,但在医学领域可能有更专业的特定译法,这里保留英文未翻译是因为不确定其确切中文专业术语,具体可根据实际情况调整。)
JAMA. 2012 Jun 6;307(21):2261-2. doi: 10.1001/jama.2012.5564.
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Reshaping US health care: from competition and confiscation to cooperation and mobilization.重塑美国医疗保健:从竞争与没收走向合作与动员。
JAMA. 2014 Nov 26;312(20):2099-100. doi: 10.1001/jama.2014.15727.
9
The role of the radiologist in new payment systems.放射科医生在新支付系统中的角色。
Abdom Radiol (NY). 2016 Mar;41(3):461-5. doi: 10.1007/s00261-016-0674-2.
10
Understanding Value-based Reimbursement Models and Trends in Orthopaedic Health Policy: An Introduction to the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.理解基于价值的报销模式及骨科卫生政策趋势:2015年医疗保险准入与儿童健康保险计划再授权法案(MACRA)简介
J Am Acad Orthop Surg. 2016 Nov;24(11):e136-e147. doi: 10.5435/JAAOS-D-16-00283.

引用本文的文献

1
Time is money: An analysis of cost drivers in ambulatory sinus surgery.时间就是金钱:门诊鼻窦手术成本驱动因素分析
Int Forum Allergy Rhinol. 2025 Feb;15(2):120-127. doi: 10.1002/alr.23455. Epub 2024 Sep 26.
2
Characteristics of Future Models of Integrated Outpatient Care.未来综合门诊护理模式的特点。
Healthcare (Basel). 2019 Apr 27;7(2):65. doi: 10.3390/healthcare7020065.
3
Quality Changes after Implementation of an Episode of Care Model with Strict Criteria for Physical Therapy in Ontario's Long-Term Care Homes.安大略省长期护理院实施具有严格物理治疗标准的护理模式后质量的变化。
Health Serv Res. 2018 Dec;53(6):4863-4885. doi: 10.1111/1475-6773.13020. Epub 2018 Aug 9.

本文引用的文献

1
Centers for Medicare & Medicaid Services' Comprehensive Care for Joint Replacement: The Present and Future for Orthopedic Surgeons.医疗保险和医疗补助服务中心的关节置换综合护理:骨科医生的现状与未来。
Orthopedics. 2017 Mar 1;40(2):77-80. doi: 10.3928/01477447-20170302-03.
2
Setting value-based payment goals--HHS efforts to improve U.S. health care.设定基于价值的支付目标——HHS 改善美国医疗保健的努力。
N Engl J Med. 2015 Mar 5;372(10):897-9. doi: 10.1056/NEJMp1500445. Epub 2015 Jan 26.
3
The perioperative surgical home (PSH): a comprehensive review of US and non-US studies shows predominantly positive quality and cost outcomes.围手术期外科之家(PSH):对美国和非美国研究的全面综述显示,其质量和成本结果大多呈积极态势。
Milbank Q. 2014 Dec;92(4):796-821. doi: 10.1111/1468-0009.12093.
4
Medicare's prospective payment system: A critical appraisal.医疗保险的前瞻性支付系统:批判性评估。
Health Care Financ Rev. 1992 Mar;1991(Suppl):45-77.
5
The Pioneer accountable care organization model: improving quality and lowering costs.先锋责任医疗组织模式:提高质量并降低成本。
JAMA. 2014;312(16):1635-6. doi: 10.1001/jama.2014.13109.
6
CMS--engaging multiple payers in payment reform.医疗保险和医疗补助服务中心——让多个支付方参与支付改革。
JAMA. 2014 May 21;311(19):1967-8. doi: 10.1001/jama.2014.3703.
7
Medicare program; Medicare Shared Savings Program: Accountable Care Organizations. Final rule.医疗保险计划;医疗保险共享储蓄计划: accountable care organizations。最终规则。 (注:Accountable Care Organizations 可译为“ accountable care organizations”,直译为“可问责医疗组织”,是美国医疗领域的一种组织形式,这里保留英文是因为在医保相关语境中可能有特定含义,具体翻译可根据实际情况调整更准确的表述。)
Fed Regist. 2011 Nov 2;76(212):67802-990.
8
Defining and measuring the patient-centered medical home.定义并衡量以患者为中心的医疗之家。
J Gen Intern Med. 2010 Jun;25(6):601-12. doi: 10.1007/s11606-010-1291-3.
9
Public reporting and pay for performance in hospital quality improvement.医院质量改进中的公开报告与绩效薪酬
N Engl J Med. 2007 Feb 1;356(5):486-96. doi: 10.1056/NEJMsa064964. Epub 2007 Jan 26.
10
Medscape's response to the Institute of Medicine Report: Crossing the quality chasm: a new health system for the 21st century.Medscape对医学研究所报告《跨越质量鸿沟:21世纪的新卫生系统》的回应。
MedGenMed. 2001 Mar 5;3(2):2.

市场评估:财务、捆绑支付与 accountable care 组织。 (注:“accountable care”可直译为“可问责医疗”,这里意译为“责任医疗”,具体翻译可根据上下文和专业习惯调整,这里为了保留英文表述方便你理解,未进行意译替换。)

Market Evaluation: Finances, Bundled Payments, and Accountable Care Organizations.

作者信息

Siddique Shazia Mehmood, Mehta Shivan J

机构信息

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.

出版信息

Anesthesiol Clin. 2017 Dec;35(4):715-724. doi: 10.1016/j.anclin.2017.08.005.

DOI:10.1016/j.anclin.2017.08.005
PMID:29101960
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6604801/
Abstract

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.

摘要

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。