摘要
节约成本并提高健康服务效果是医保支付方式改革的重要任务。近年来,美国针对以价值为导向的医保支付模式展开了深入探索,家庭健康服务的医保支付取得积极进展。在文献检索的基础上,通过总结美国以价值为导向医保支付模式的基本现状、管理机制、模式开发与实施等领域的经验,从基金支付方式转变、风险调整机制优化、竞争合作机制以及配套措施建设等多个维度为发展我国长期护理保险的实践探索提供参考。
Saving costs and improving the effectiveness of health services are important tasks in the reform of medical insur-ance payment.In recent years,in-depth exploration of value-based healthcare payment models has conducted in the United States,and positive progress has been obtained in the field of home health services.Based on literature review,the basic status,management mechanisms,model development and implementation experience of the home health value-based purchasing in the United States were summarized,and references for the exploration of long-term care insurance in China were provided,including the transformation of fund payment methods,optimization of risk adjustment mechanism,construction of competition/cooperation mechanism and other supporting measures.
作者
刘稳
尹述颖
荣超
Liu Wen(School of Humanities and Management,Zhejiang chinese Medical University,Hangzhou,P.R.China)
出处
《中国卫生事业管理》
北大核心
2024年第8期846-850,895,共6页
Chinese Health Service Management
基金
浙江省科学技术厅省软科学研究项目“浙江省慢性病健康管理服务整合协同机制及优化路径研究——基于健康治理视角”(2024C35060)
浙江省社科领军人才培育专项课题“大数据驱动下中医药特色居家医养结合综合服务能力评价与促进策略研究”(21QNYC16ZD)
浙江中医药大学2023年社会科学青年探索项目“健康老龄化背景下长期护理服务优化策略研究”(2023JKSKTS04)。
关键词
价值支付
绩效
家庭健康服务
长期护理保险
value-based purchasing
performance
home health services
long-term care insurance
