Provider Reimbursement Following the Affordable Care Act.

Q2 Nursing Health Care Manager Pub Date : 2018-04-01 DOI:10.1097/HCM.0000000000000205
Brandon Bowling, David Newman, Craig White, Ashley Wood, Alberto Coustasse
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引用次数: 15

Abstract

Decreasing health care expenditures has been one of the main objectives of the Affordable Care Act. To achieve this goal, the Centers for Medicare and Medicaid Services (CMS) has been tasked with experimenting with provider reimbursement methods in an attempt to increase quality, while decreasing costs. The purpose of this research was to study the effects of the Affordable Care Act on physician reimbursement rates from CMS to determine the most cost-effective method of delivering health care services. The CMS has experimented with payment methods in an attempt to increase cost-effectiveness. Medicare has offered shared cost-savings incentives to reward quality care to both primary care providers and preventative services. The CMS has determined fee-for-service payments obsolete, opting instead for a value-based purchasing method of payment. Although a universal payment method has yet to be adopted, it has been evident that a value-based purchasing model and preventative care can be used to decrease health care expenditure.

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根据平价医疗法案,医疗服务提供者报销。
减少医疗保健支出一直是《平价医疗法案》的主要目标之一。为了实现这一目标,医疗保险和医疗补助服务中心(CMS)已经承担了试验提供者报销方法的任务,试图在降低成本的同时提高质量。本研究的目的是研究《平价医疗法案》对CMS的医生报销率的影响,以确定提供医疗服务的最具成本效益的方法。为了提高成本效益,医疗保险系统已经尝试了多种支付方式。医疗保险提供了共同节约成本的激励措施,以奖励初级保健提供者和预防性服务的优质护理。CMS已经确定按服务收费的支付方式已经过时,取而代之的是基于价值的购买支付方式。虽然尚未采用普遍支付方法,但显然可以采用基于价值的购买模式和预防性保健来减少保健支出。
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来源期刊
Health Care Manager
Health Care Manager HEALTH POLICY & SERVICES-
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期刊介绍: The Health Care Manager (HCM), provides practical, applied management information for managers in institutional health care settings. It is a quarterly journal, horizontally integrated and cutting across all functional lines, written for every person who manages the work of others in any health care setting. This journal presents practical day-to-day management advice as well as research studies addressing current issues in health care management. Its intent is the strengthening management and supervisory skills of its readers and increasing their understanding of today"s health care environment. HCM is searchable through PubMed.
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