Stevens James C
Fort Wayne Neurological Center and Indiana University School of Medicine, Fort Wayne, IN.
Neurol Clin Pract. 2013 Aug;3(4):341-347. doi: 10.1212/CPJ.0b013e3182a1b8bd.
Over the past decade, health care in the United States has been a topic of intense political debate, resulting in dramatic legislative, regulatory, and economic changes. These changes have occurred due to the unsustainable rise of health care costs without accompanying improvement in measured health outcomes when compared to other economically developed countries. In an attempt to contain costs and improve the quality of health care provided, the Center for Medicare and Medicaid Services has implemented 4 distinct incentive-based programs. Data are scarce concerning whether such programs will be successful in accomplishing these goals. Each health care provider will need to weigh the costs of participation against the fines incurred by nonparticipation (up to 10% of annual Medicare payments). Knowledge of the percentage of one's practice dedicated to the care of patients in the Medicare and Medicaid programs will be helpful in arriving at a final decision.
在过去十年中，美国的医疗保健一直是激烈政治辩论的话题，导致了巨大的立法、监管和经济变革。与其他经济发达国家相比，这些变革的发生是由于医疗保健成本的不可持续上升，而衡量的健康结果却没有相应改善。为了控制成本并提高所提供医疗保健的质量，医疗保险和医疗补助服务中心实施了4个不同的基于激励的项目。关于这些项目能否成功实现这些目标的数据很少。每个医疗保健提供者都需要权衡参与的成本与不参与所产生的罚款（高达年度医疗保险支付的10%）。了解自己的业务中为医疗保险和医疗补助项目中的患者提供护理的比例，将有助于做出最终决定。
