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从利用管理角度管理质量:提供者视角

Managing quality from the utilization management perspective: the provider view.

作者信息

Miles K S

机构信息

Vanderbilt Health Services, Vanderbilt University Medical Center, Nashville, TN 37203, USA.

出版信息

Semin Nurse Manag. 1997 Sep;5(3):144-8.

PMID:9348998
Abstract

As a contracted provider for a popular health maintenance organization, you receive notice that it is converting its provider contracts to capitated reimbursement models. Reluctantly, you read to see how this change affects your practice. Are you positioned to accept "risk" for your patients? How will you manage your risk? Can you afford to terminate your relationship with this managed care organization and lose your patients to providers who are eager to expand their practice and patient base? This article presents an overview of capitation and ways to manage capitation while promoting quality care and outcomes for your patients.

摘要

作为一家知名健康维护组织的签约供应商,你收到通知,该组织正在将其供应商合同转换为按人头付费的报销模式。你不情愿地阅读,想看看这一变化将如何影响你的业务。你是否准备好为你的患者承担“风险”?你将如何管理风险?你能否承受与这个管理式医疗组织终止合作关系,而让你的患者流失到那些急于扩大业务和患者群体的供应商那里?本文概述了按人头付费以及在为患者提供优质护理和良好结果的同时管理按人头付费的方法。

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