Paris M
Med Care. 1976 Sep;14(9):777-93. doi: 10.1097/00005650-197609000-00005.
Faced with constantly increasing costs for the provision of laboratory services to Medicaid recipients, the New York City Department of Health last year attempted to implement a program to fundamentally restructure the organizational patterns and financing mechanisms of New York City's clinical laboratory industry. The program, based on competitive bidding, gave one laboratory in each of New York's five boroughs exclusive rights to process Medicaid lab samples and replaced presently existing fee-for-service reimbursement mechanisms with a unique system combining unit pricing and capitation. This paper outlines the principal provisions of the City's proposed contract, analyzes the underlying motivations of the City's decision, and describes the reactions of the existing laboratory service delivery system. In addition, the generic problems of implementing effective administrative techniques for cost and quality control of laboratory services are discussed.
面对为医疗补助受助者提供实验室服务的成本不断增加的情况，纽约市卫生部去年试图实施一项计划，从根本上重组纽约市临床实验室行业的组织模式和融资机制。该计划基于竞争性投标，赋予纽约五个行政区每个区的一家实验室处理医疗补助实验室样本的专有权，并用一种将单位定价和总额预算相结合的独特系统取代现有的按服务收费报销机制。本文概述了该市拟议合同的主要条款，分析了该市做出这一决定的潜在动机，并描述了现有实验室服务提供系统的反应。此外，还讨论了在实验室服务的成本和质量控制方面实施有效管理技术的一般问题。
