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Preparing for a value-driven future.
Families, Systems, & Health ( IF 1.3 ) Pub Date : 2020-03-01 , DOI: 10.1037/fsh0000476
Suzanne Daub 1 , Caroline Rosenzweig 1 , Meggan Christman Schilkie 1
Affiliation  

At this month's staff meeting of your integrated primary care practice, the medical director makes an announcement: Your health system just signed a contract that includes a value-based payment (VBP) arrangement with a local managed care organization (MCO). The medical director suggests that this will lead to big changes in your practice because you will now focus on producing patient outcomes rather than on volume of care delivered. You wonder: What is a VBP arrangement? What kinds of patient outcomes? What does this mean for integrated care? and How do I help our organization succeed? Value-based care is the future, and it will impact the way that all of us practice. In value-based arrangements, the delivery of care fundamentally changes because payment for care shifts from our current fee-for-service model, in which provider productivity is key to financial survival, to payment for positive clinical outcomes where quality of care rules. And this change is happening now. In 2015, the U.S. Department of Health and Human Services announced aggressive national VBP targets, with a goal of tying 50% of all Medicare payments to alternative payment models by the end of 2018 (New York State Department of Health, 2015). Since then, many states have adopted similar targets for their Medicaid programs in light of ongoing state budget challenges and unsustainable cost growth trends. As these changes take hold, health care providers are increasingly expected to make fundamental changes to service delivery, financial, and organizational operations. As health care providers, VBP will require us and our health centers to develop new skills, capacities, and systems for managing clinical, financial, and operational performance and risk. We must all make sure we understand and are ready to play our part in the transition to VBP. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译:

为价值驱动的未来做准备。

在本月您的综合初级保健实践的员工会议上,医疗主管宣布:您的卫生系统刚刚与当地的托管医疗组织(MCO)签订了包括基于价值的付款(VBP)安排的合同。医疗主任建议,这将导致您的做法发生重大变化,因为您现在将专注于产生患者结果,而不是所提供的护理数量。您想知道:什么是VBP安排?什么样的患者预后?这对综合护理意味着什么?以及我如何帮助我们的组织成功?基于价值的护理是未来,它将影响我们所有人的实践方式。在基于价值的安排中,护理的提供从根本上发生了变化,因为护理的支付方式已从我们当前的按服务付费模式转移,在这种情况下,提供者的生产力是财务生存的关键,而在护理质量决定标准的情况下,要为获得积极的临床结果付费。现在,这种变化正在发生。2015年,美国卫生与公共服务部宣布了宏伟的国家VBP目标,目标是到2018年底将所有Medicare付款的50%绑定到替代支付模式(纽约州卫生部,2015年)。从那时起,鉴于州预算持续面临挑战和成本增长趋势不可持续,许多州在医疗补助计划中也采用了类似的目标。随着这些变化的发生,人们越来越期望医疗保健提供者对服务提供,财务和组织运营进行根本性的变化。作为医疗保健提供者,VBP将要求我们和我们的医疗中心开发新的技能,能力,以及用于管理临床,财务和运营绩效与风险的系统。我们都必须确保我们了解并准备在向VBP过渡中发挥自己的作用。(PsycInfo数据库记录(c)2020 APA,保留所有权利)。
更新日期:2020-03-01
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