评估负责医疗组织的供应商合作伙伴关系。
Assessing Provider Partnerships For Accountable Care Organizations.
作者信息
Muhlestein David, de Lisle Katelyn, Merrill Thomas
机构信息
Leavitt Partners, Salt Lake City, Utah.
出版信息
Manag Care. 2018 Mar;27(3):40-49.
PURPOSE
Understand current provider approaches to the evaluation of various partnerships under accountable care contracts and create a framework to help accountable care organizations (ACOs) better assess their partnerships.
DESIGN
Study included (1) an in-depth literature review of materials describing high-value health care organizations as a foundation for draft framework development, (2) an expert panel convened to evaluate the framework and help prioritize provider types to evaluate, and (3) interviews with representatives of ACOs and entities representing various types of health care providers.
METHODOLOGY
Authors created a draft partnership framework derived from the literature review for expert panel feedback. An updated draft framework was then shared with active ACO leaders prior to qualitative interviews. All interviews were transcribed and coded using a mixed-methods analysis platform.
RESULTS
We found little research that took a comprehensive view of health care provider competencies and characteristics and by extension few resources to help ACOs fill competency gaps through partnerships. The ACOs interviewed were all actively engaged in provider partnerships and were learning and establishing best practices for provider partnerships.
CONCLUSIONS
Accountable care offers incentives for entities to improve the cost and quality of health care. To accomplish this in an effective way, ACOs must recognize the needs of their assigned populations and work to provide comprehensive care management across the spectrum of provider types. Accomplishing this will also require ACOs to create novel partnership arrangements and learn how to manage populations most effectively. ACOs need a framework for evaluating potential partners that will help risk-bearing providers establish the partnerships that will enable them to achieve their goals. This paper makes specific recommendations on how state and federal policy could facilitate better and more effective provider partnerships.
目的
了解当前医疗服务提供者对按病种付费合同下各种合作关系的评估方法,并创建一个框架来帮助负责医疗组织(ACO)更好地评估其合作关系。
设计
该研究包括:(1)对描述高价值医疗保健组织的材料进行深入文献综述,作为制定框架草案的基础;(2)召集专家小组评估该框架,并帮助确定要评估的医疗服务提供者类型的优先级;(3)对ACO代表以及代表各类医疗服务提供者的实体进行访谈。
方法
作者根据文献综述创建了一个合作关系框架草案,以获取专家小组的反馈。然后在进行定性访谈之前,将更新后的框架草案分享给活跃的ACO领导者。所有访谈均进行转录,并使用混合方法分析平台进行编码。
结果
我们发现很少有研究全面审视医疗服务提供者的能力和特征,因此也几乎没有资源可帮助ACO通过合作关系填补能力差距。接受访谈的ACO都积极参与与医疗服务提供者的合作关系,并正在学习和确立医疗服务提供者合作关系的最佳实践。
结论
按病种付费为各实体改善医疗保健成本和质量提供了激励措施。为了有效实现这一目标,ACO必须认识到其服务对象的需求,并努力在各类医疗服务提供者范围内提供全面的护理管理。要实现这一点,还需要ACO创建新颖的合作安排,并学习如何最有效地管理服务对象。ACO需要一个评估潜在合作伙伴的框架,这将有助于承担风险的医疗服务提供者建立能够实现其目标的合作关系。本文就州和联邦政策如何促进更好、更有效的医疗服务提供者合作关系提出了具体建议。