Robert A. Berenson is an institute fellow at the Urban Institute, in Washington, D.C. He recently completed a three-year term on the Physician-Focused Payment Model Technical Advisory Committee, which is discussed in the article.
Paul B. Ginsburg (
Health Aff (Millwood). 2019 Feb;38(2):246-252. doi: 10.1377/hlthaff.2018.05411.
Alternative Payment Models (APMs) can address the limitations inherent in fee-for-service payment to support new approaches to health care delivery that produce greater value. But the models being tested are directly layered on top of fee-for-service architecture, specifically the Medicare Physician Fee Schedule. Shoring up that architecture to produce greater value, in combination with APMs, should be considered an integral part of the movement to value-based payment. We propose ending the split within the Centers for Medicare and Medicaid Services between the people managing the Medicare Physician Fee Schedule and those creating and testing APMs, with both groups advised by a revamped Physician-Focused Payment Model Technical Advisory Committee that covers both dimensions of creating greater value.
可支付性模式（APM）可以解决按服务收费支付中固有的局限性，支持产生更大价值的新的医疗保健提供方式。但是，正在测试的模式是直接在按服务收费架构之上构建的，特别是医疗保险医师费用表。加强该架构以产生更大的价值，与 APM 相结合，应被视为向基于价值的支付转变的一个组成部分。我们建议结束医疗保险和医疗补助服务中心内部在管理医疗保险医师费用表的人和创建及测试 APM 的人之间的分歧，由一个经过改组的、同时涵盖创造更大价值的两个方面的医师为重点的支付模式技术咨询委员会为这两个组提供建议。
