Nelson Melody Boudreaux, Lamendola-Essel Michelle F, Odegard Aaron, Whitehead Stephanie, Baker Dana Powell, Nakitandwe Joy
Department of Pathology and Laboratory Medicine, University of Kansas Health System, Kansas City, KS, United States of America.
Department of Medicine, NYU Grossman School of Medicine, New York, NY, United States of America.
Dialogues Health. 2024 Aug 20;5:100187. doi: 10.1016/j.dialog.2024.100187. eCollection 2024 Dec.
Under the collective weight of growing test volume, staffing constraints, and Medicare reimbursements cuts, an enhancement-based, alternative payment structure focused on rewarding the laboratory's care delivery efforts via benchmarking is appealing. However, achieving a value-based payment model requires the development of an inclusive laboratory care delivery model (LCDM) framework. Today, a holistic, practical LCDM framework for laboratory medicine does not exist. However, such creation is essential for establishing unifying tenants of practice for value-tracing by which standardized key performance and population health indicators can be derived. LAB-CARES is the first step in formulating an LCDM with the primary objective of defining and streamlining the processes and strategies necessary to deliver and articulate the value of diagnostic excellence across the healthcare system. The goal of LAB-CARES is to maximize efficiencies, enhance quality, disseminate clinical expertise, increase patient safety, and promote integrative practice. LAB-CARES is designed to improve an individual patient's quality of life (longitudinal laboratory results - beyond one test) and their surrounding communities (e.g., through surveillance and prevention - beyond one patient). Further professional conversation and efforts are paramount to integrate LAB-CARES as a formalized structure within the healthcare landscape.
在检测量不断增加、人员配备受限以及医疗保险报销削减的共同压力下,一种基于基准评估、以奖励实验室护理服务努力为重点的增强型替代支付结构颇具吸引力。然而,要实现基于价值的支付模式,需要开发一个包容性的实验室护理服务模式(LCDM)框架。目前,尚不存在一个全面、实用的检验医学LCDM框架。然而,这样的框架对于确立统一的实践原则以进行价值追踪至关重要,通过该原则可以得出标准化的关键绩效指标和人群健康指标。LAB-CARES是制定LCDM的第一步,其主要目标是定义和简化在整个医疗系统中提供并阐明卓越诊断价值所需的流程和策略。LAB-CARES的目标是实现效率最大化、提高质量、传播临床专业知识、增强患者安全并促进综合实践。LAB-CARES旨在改善个体患者的生活质量(纵向实验室结果——不止一次检测)及其周边社区(例如,通过监测和预防——不止针对一名患者)。进一步的专业交流和努力对于将LAB-CARES整合为医疗领域的正式结构至关重要。