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基于价值的医疗支付模式:对患者和临床医生来说是披着羊皮的狼。

Value-based healthcare payment models: a wolf in sheep's clothing for patients and clinicians.

作者信息

Bohler Forrest, Garden Allison, Brock Callaham, Bohler Lily

机构信息

Oakland University William Beaumont School of Medicine, Rochester, MI, USA.

Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, SC, USA.

出版信息

Ann Med. 2024 Dec;56(1):2382948. doi: 10.1080/07853890.2024.2382948. Epub 2024 Jul 24.

Abstract

Value-based healthcare payment models are an alternative insurance payment system that compensates healthcare providers based on their patients' outcomes rather than the individual services healthcare workers provide. This shift from the current fee-for-service model that predominates our medical system has received renewed popularity and attention within organized medicine such as the American Medical Association. Advocates believe that this new payment model will address many of the unsolved issues in healthcare such as medical waste and unsustainable healthcare costs. In practice, however, this model is plagued with a myriad of unresolved issues of its own. In this commentary, we outline these issues and suggest that the intentions of those advocating for value-based payment models are either misguided or disingenuous. We then offer solutions that preserve our current fee-for-service model while making necessary changes that will benefit both physicians and patients nationwide.

摘要

基于价值的医疗支付模式是一种替代性保险支付系统,它根据医疗服务提供者的患者治疗结果而非医护人员提供的单项服务来对其进行补偿。从目前主导我们医疗系统的按服务收费模式的这种转变,在美国医学协会等有组织的医学界中重新受到欢迎并引起关注。倡导者认为,这种新的支付模式将解决医疗保健中的许多未解决问题,如医疗浪费和不可持续的医疗成本。然而,在实践中,这种模式本身也存在无数未解决的问题。在这篇评论中,我们概述了这些问题,并认为倡导基于价值的支付模式的人的意图要么是被误导的,要么是不真诚的。然后,我们提供了一些解决方案,既能保留我们目前的按服务收费模式,又能做出必要的改变,使全国的医生和患者都受益。

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