Cizmic Zlatan, Nunley Ryan M, O'Neill Owen, Bosco Joseph A, Iorio Richard
Instr Course Lect. 2019;68:659-674.
Alternative payment models are constantly evolving in an attempt to create value by decreasing cost while improving or maintaining quality. The Bundled Payments for Care Improvement initiative was implemented in 2011, and many institutions have seen early success by using the seven pillars of total joint arthroplasty episode management. Private insurers have seen improvements in care and cost savings by adopting private bundle programs. In each organization, alignment among all stakeholders is paramount to the success of the bundled payment programs. Gainsharing offers a unique opportunity to incentivize physicians to change their care practices in an attempt to reduce costs and improve outcomes. As bundled payments evolve, the cooperation of physicians, health care institutions, payers, and patients will lead to value creation for all stakeholders.
替代性支付模式在不断发展，试图通过降低成本同时提高或维持质量来创造价值。“改善护理的捆绑支付倡议”于2011年实施，许多机构通过运用全关节置换术事件管理的七大支柱取得了早期成功。私人保险公司通过采用私人捆绑计划，在护理改善和成本节约方面取得了成效。在每个组织中，所有利益相关者之间的协调一致对于捆绑支付计划的成功至关重要。收益共享提供了一个独特的机会，激励医生改变他们的护理方式，以降低成本并改善结果。随着捆绑支付的发展，医生、医疗机构、支付方和患者之间的合作将为所有利益相关者创造价值。
