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Long-term care and pay-for-performance programs

机译：长期护理和按绩效付费计划

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Pay-for-performance programs are gradually spreading across Asia. This paper builds on the longer experience in the United States to offer lessons for Asia. The Center for Medicare and Medicaid Services has introduced several pay-for-performance programs since 2012 to encourage hospitals to improve quality of care and reduce costs. Some state Medicaid programs have also introduced pay-for-performance for nursing homes. Long-term care providers play an important role in hospital pay-for-performance programs because they can affect the readmission rate and also total episode payments. A good pay-for-performance program will focus on improving quality of care that affects health outcomes. In addition, that quality must vary across providers and be measurable. Furthermore, it is important that the measures be reported in a timely way, that both demand and supply respond to the measures, and that the measures be risk adjusted. Empirical data from Medicare beneficiaries in the state of Michigan show that mean episode payments and readmission rates in skilled nursing facilities vary widely and are sensitive to the number of observations. These practical matters create challenges for implementing pay-for-performance in practice. There is an extensive literature review of pay-for-performance in long-term care in the United States and in Asia.
机译：按绩效付费计划正在亚洲范围内逐步推广。本文基于在美国的长期经验为亚洲提供经验教训。自2012年以来，医疗保险和医疗补助服务中心引入了一些按绩效付费计划，以鼓励医院提高护理质量并降低成本。一些州的医疗补助计划还引入了按绩效付费的养老院。长期护理提供者在医院按绩效付费计划中起着重要作用，因为它们会影响再入院率以及总发作费用。一个好的绩效绩效计划将重点放在改善会影响健康结果的护理质量上。另外，该质量必须在提供商之间变化并且是可衡量的。此外，重要的是应及时报告措施，供需双方都应对措施，并对措施进行风险调整。来自密歇根州医疗保险受益人的经验数据表明，熟练护理机构的平均发作支付和再入院率差异很大，并且对观察数敏感。这些实际问题为实践中按绩效付费提出了挑战。在美国和亚洲，有关长期护理绩效报酬的文献广泛。

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