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CardioVascular Care Providers. A pioneer in bundled services, shared risk, and single payment.心血管护理服务提供商。在捆绑服务、分担风险和单一支付方面的先驱。
Tex Heart Inst J. 1995;22(1):72-6.
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本文引用的文献

1
Is this the beginning of DRGs for doctors?这会是针对医生的疾病诊断相关分组(DRGs)的开端吗?
Med Econ. 1989 Jan 16;66(2):27-8, 33-4, 36.
2
Effects of surgeon volume and hospital volume on quality of care in hospitals.外科医生手术量和医院手术量对医院医疗质量的影响。
Med Care. 1987 Jun;25(6):489-503. doi: 10.1097/00005650-198706000-00004.
3
Association of volume with outcome of coronary artery bypass graft surgery. Scheduled vs nonscheduled operations.
JAMA. 1987 Feb 13;257(6):785-9.
4
The volume-outcome relationship: practice-makes-perfect or selective-referral patterns?容量-结局关系:熟能生巧还是选择性转诊模式?
Health Serv Res. 1987 Jun;22(2):157-82.
5
Investigation of the relationship between volume and mortality for surgical procedures performed in New York State hospitals.纽约州医院实施的外科手术中体积与死亡率之间关系的调查。
JAMA. 1989 Jul 28;262(4):503-10.
6
Adult open heart surgery in New York State. An analysis of risk factors and hospital mortality rates.纽约州的成人心脏直视手术。风险因素与医院死亡率分析。
JAMA. 1990 Dec 5;264(21):2768-74.
7
Surgical care for the uninsured and underinsured.
Arch Surg. 1991 May;126(5):549-50. doi: 10.1001/archsurg.1991.01410290021001.
8
Differences in mortality from coronary artery bypass graft surgery at five teaching hospitals.五家教学医院冠状动脉搭桥手术死亡率的差异。
JAMA. 1991 Aug 14;266(6):810-5.

心血管护理服务提供商。在捆绑服务、分担风险和单一支付方面的先驱。

CardioVascular Care Providers. A pioneer in bundled services, shared risk, and single payment.

作者信息

Edmonds C, Hallman G L

机构信息

CardioVascular Care Providers, Houston, TX 77030, USA.

出版信息

Tex Heart Inst J. 1995;22(1):72-6.

PMID:7787473
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC325213/
Abstract

In 1984, physicians at the Texas Heart Institute developed CardioVascular Care Providers, Inc., the 1st packaged pricing plan for cardiovascular surgery. Under this arrangement, all services (including physician and hospital charges) are covered by a global payment package (bundled service). The resulting flat fee is lower than the sum of the individual charges. Since November 1984, the plan has been offered to the non-Medicare (< 65-year-old) population through contracts with self-insured corporations, prepaid health plans, union trusts, and foreign governments. In 1993, it was extended to Medicare patients who require coronary artery bypass grafting. Our experience has shown that the plan lowers costs, increases patient access, allows payers to forecast their expenses, and streamlines the billing process, while maintaining a high quality of care and enabling patients to choose their own providers. Our success with this approach is attributed not only to the plan's simplicity but also to the fact that it is physician-directed and organ-specific, involving many related specialties. Equally important keys to success include our hospital's large patient population and extensive database. Similar packaged pricing plans have been adopted by several other cardiovascular centers. The approach is now being evaluated by Medicare in 6 other hospitals nationwide. With time, this approach is likely to become an increasingly popular reimbursement option.

摘要

1984年,得克萨斯心脏研究所的医生们创立了心血管护理服务公司,这是首个心血管外科手术的打包定价方案。在这种安排下,所有服务(包括医生和医院收费)都包含在一个整体支付套餐(捆绑服务)中。由此产生的固定费用低于各项单独收费的总和。自1984年11月以来,该方案已通过与自保公司、预付健康计划、工会信托及外国政府签订合同,提供给非医疗保险人群(年龄<65岁)。1993年,该方案扩展至需要冠状动脉搭桥手术的医疗保险患者。我们的经验表明,该方案降低了成本,增加了患者获得治疗的机会,使付款人能够预测其费用,并简化了计费流程,同时保持了高质量的护理水平,并使患者能够选择自己的医疗服务提供者。我们采用这种方法取得成功,不仅归因于该方案的简单性,还归因于它由医生主导且针对特定器官,涉及许多相关专业。同样重要的成功关键包括我们医院庞大的患者群体和广泛的数据库。其他几家心血管中心也采用了类似的打包定价方案。目前,医疗保险正在全国其他6家医院对这种方法进行评估。随着时间的推移,这种方法可能会成为越来越受欢迎的报销选择。