Millwee Billy, Quinn Kevin, Goldfield Norbert
Millwee & Associates, Dripping Springs, Texas (Mr Millwee); 3M Health Information Systems, Wallingford, Connecticut (Mr Quinn and Dr Goldfield); St Peter's Hospital, Helena, Montana (Mr Quinn); and Baystate Medical Center, Springfield, Massachusetts (Dr Goldfield).
J Ambul Care Manage. 2018 Apr/Jun;41(2):88-94. doi: 10.1097/JAC.0000000000000232.
Medicaid can improve beneficiary health and help sustain its own future by embracing payment for outcomes. Good precedents exist from states such as Florida, Maryland, Minnesota, New York, Ohio, Pennsylvania, and Texas. Medicaid outcome measures include preventable admissions, readmissions, emergency department visits, and inpatient complications; early elective deliveries; infant and child mortality; patient-reported outcomes, satisfaction, and confidence; and reduction in low-value care. Criteria to prioritize initiatives include potential savings, availability of established models, impact on health status, and Medicaid's ability to effect change. We offer 5 principles for success, emphasizing clinically credible initiatives that generate actionable information for clinicians.
医疗补助计划可以通过采用基于结果的支付方式来改善受益人的健康状况，并有助于维持其自身的未来发展。佛罗里达州、马里兰州、明尼苏达州、纽约州、俄亥俄州、宾夕法尼亚州和得克萨斯州等州已有良好的先例。医疗补助计划的结果衡量指标包括可预防的入院、再入院、急诊就诊和住院并发症；早期择期分娩；婴儿和儿童死亡率；患者报告的结果、满意度和信心；以及减少低价值医疗服务。确定优先举措的标准包括潜在节省费用、现有模式的可用性、对健康状况的影响以及医疗补助计划实现变革的能力。我们提出了5条成功原则，强调开展临床上可信的举措，为临床医生生成可采取行动的信息。
