Stanford, Calif.; and New York, N.Y.
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Clinical Excellence Research Center, Department of Medicine, Stanford University; and the Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center.
Plast Reconstr Surg. 2018 Feb;141(2):294-300. doi: 10.1097/PRS.0000000000004019.
Rising health care costs and quality demands have driven both the Centers for Medicare and Medicaid Services and the private sector to seek innovations in health system design by placing institutions at financial risk. Novel care models, such as bundled reimbursement, aim to boost value though quality improvement and cost reduction. The Center for Medicare and Medicaid Innovation is leading the charge in this area with multiple pilots and mandates, including Comprehensive Care for Joint Replacement. Other high-cost and high-volume procedures could be considered for bundling in the future, including breast reconstruction. In this article, conceptual considerations surrounding bundling of breast reconstruction are discussed.
不断上涨的医疗保健成本和对高质量的需求,促使医疗保险和医疗补助服务中心(Centers for Medicare and Medicaid Services)和私营部门通过使医疗机构面临财务风险,寻求医疗体系设计方面的创新。新颖的护理模式,如捆绑式报销,旨在通过提高质量和降低成本来提高价值。医疗保险和医疗补助创新中心(Center for Medicare and Medicaid Innovation)在这一领域开展了多项试点和授权工作,包括人工关节置换全面护理。未来可能会考虑对其他高成本和高数量的手术进行捆绑,包括乳房重建。本文讨论了围绕乳房重建捆绑的概念性考虑。