Obstet Gynecol. 2018 Aug;132(2):e53-e59. doi: 10.1097/AOG.0000000000002753.
Unsustainable health care costs combined with suboptimal patient outcomes have led health policy experts and payers to consider value-based payment or alternative payment models. Replacing fee-for-service reimbursement, these models link payment to value by rewarding efforts to enhance the quality of care at similar or reduced costs. Although many of the models employed to date have focused on primary care, management of chronic disease in the Medicare population, and episodes of care for common procedures, models for primary and specialty care of women are in the early stages of development. As specialists in women's health, obstetrician-gynecologists need to be actively engaged in this fundamental shift in the payment and delivery system.
医疗保健成本的不可持续性以及不尽如人意的患者治疗效果，使得卫生政策专家和支付方考虑采用基于价值的支付方式或其他支付模式。这些模式通过奖励提高医疗质量的努力，在相似或降低成本的情况下支付费用，取代了按服务收费的报销方式，将支付与价值联系起来。虽然迄今为止采用的许多模式都集中在初级保健、医疗保险人群的慢性病管理以及常见手术的护理过程，但初级保健和专科保健的模式仍处于发展初期。作为妇女健康专家，妇产科医生需要积极参与支付和交付系统的这一根本性转变。
