截至 2023 年的医疗保险急性期后护理报销模式:过去、现在和未来。

IF 4.4 1区 医学 Q1 ORTHOPEDICS Journal of Bone and Joint Surgery, American Volume Pub Date : 2024-08-21 Epub Date: 2024-04-23 DOI:10.2106/JBJS.23.00422
Ahmed Siddiqi, Ignacio Pasqualini, Joshua Tidd, Pedro J Rullán, Alison K Klika, Trevor G Murray, Joshua K Johnson, Nicolas S Piuzzi
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引用次数: 0

摘要

医疗保险与医疗补助服务中心一直在努力减少不必要的开支,尤其是在急性期后护理 (PAC) 方面。联邦医疗保险通过不同的模式对矫形外科医生的服务进行补偿,包括收费服务、捆绑支付和择优奖励支付系统。这些模式的目标是提高医疗质量、降低医疗成本,并鼓励医疗服务提供者采用创新、高效的医疗实践。本文深入探讨了每种支付模式对骨科手术领域的影响,重点介绍了它们的独特之处、激励措施以及对 PAC 设置的潜在影响。通过考虑历史、当前和未来的医疗保险报销模式,我们希望根据 PAC 环境中患者和医疗服务提供者的特定需求,提供对最佳支付模式的理解。
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Medicare's Post-Acute Care Reimbursement Models as of 2023: Past, Present, and Future.

Abstract: The Centers for Medicare & Medicaid Services is continually working to mitigate unnecessary expenditures, particularly in post-acute care (PAC). Medicare reimburses for orthopaedic surgeon services in varied models, including fee-for-service, bundled payments, and merit-based incentive payment systems. The goal of these models is to improve the quality of care, reduce health-care costs, and encourage providers to adopt innovative and efficient health-care practices.This article delves into the implications of each payment model for the field of orthopaedic surgery, highlighting their unique features, incentives, and potential impact in the PAC setting. By considering the historical, current, and future Medicare reimbursement models, we hope to provide an understanding of the optimal payment model based on the specific needs of patients and providers in the PAC setting.

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来源期刊
CiteScore
8.90
自引率
7.50%
发文量
660
审稿时长
1 months
期刊介绍: The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.
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