1 Department of Gerontology and Geriatrics, University of Washington , Seattle, Washington.
3 Discern Health , Baltimore, Maryland.
J Palliat Med. 2018 Mar;21(S2):S81-S87. doi: 10.1089/jpm.2017.0583. Epub 2017 Dec 1.
Innovation is needed to improve care of the seriously ill, and there are important opportunities as we transition from a volume- to value-based payment system. Not all seriously ill are dying; some recover, while others are persistently functionally impaired. While we innovate in service delivery and payment models for the seriously ill, it is important that we concurrently develop accountability that ensures a focus on high-quality care rather than narrowly focusing on cost containment. The Gordon and Betty Moore Foundation convened a meeting of 45 experts to arrive at guiding principles for measurement, create a starter measurement set, specify a proposed definition of the denominator and its refinement, and identify research priorities for future implementation of the accountability system. A series of articles written by experts provided the basis for debate and guidance in formulating a path forward to develop an accountability system for community-based programs for the seriously ill, outlined in this article. As we innovate in existing population-based payment programs such as Medicare Advantage and develop new alternative payment models, it is important and urgent that we develop the foundation for accountability along with actionable measures so that the healthcare system ensures high-quality person- and family-centered care for persons who are seriously ill.
需要创新来改善重病患者的护理,而随着我们从基于数量的支付系统向基于价值的支付系统过渡,也有重要的机会。并非所有重病患者都在走向死亡;有些患者康复了,而有些患者则持续存在功能障碍。在我们为重病患者的服务提供和支付模式进行创新的同时,重要的是我们要同时发展问责制,以确保关注高质量的护理,而不是狭隘地关注成本控制。戈登和贝蒂·摩尔基金会召集了 45 名专家举行会议,以制定衡量的指导原则,创建一个初始衡量集,具体说明分母的拟议定义及其细化,并确定未来实施问责制系统的研究重点。一系列专家撰写的文章为制定社区重病患者计划问责制系统提供了辩论和指导的基础,本文对此进行了概述。随着我们对现有的基于人群的支付计划(如医疗保险优势计划)进行创新,并开发新的替代支付模式,重要且紧迫的是,我们要在制定问责制的同时制定可操作的措施,以便医疗保健系统为重病患者提供高质量的以患者和家庭为中心的护理。