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Interview with Amy Boutwell, MD, MPP

机译：采访艾米Boutwell，MD，MPP

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When I started CHS in 2011, the overall climate was more difficult. There was a lot of misunderstanding about the coverage and cost containment components of the Affordable Care Act (ACA), and debate on healthcare coverage overshadowed the delivery system transformation work (i.e., the imperative from a macroeconomic perspective to control healthcare cost growth once expanded coverage had been achieved). From a market perspective, there were years of a bimodal response by providers. Early adopters rushed to participate in the CMS Innovation Center programs, whereas other providers did nothing, believing that the American Hospital Association and other market interest groups would succeed in lobbying against some of the performance-based market incentives. Now, in 2018, there is less policy uncertainty and market uncertainty as compared to 8 years ago. With regard to reducing readmissions and avoidable hospital use, policy has been remarkably consistent despite the vibrant debate in the academic community! The delivery system's progress is seen in the clear transition away from fee-for-service and towards value-based payment, with a growing number of accountable care organizations, participants in value-based contracting, and millions of patients managed under these new arrangements. Most health system leaders know that we are on a clear path toward alternative payment models that reward value and not volume.
机译：当我在2011年开始CHS时，整体气候变得更加困难。关于经济实惠护理法案（ACA）的覆盖率和成本遏制组成部分的覆盖率和成本遏制组成部分，以及关于医疗保健覆盖的辩论黯然失色（即宏观经济视角控制医疗保健成本增长一旦扩大覆盖率已经实现了）。从市场的角度来看，供应商有多年的双峰反应。早期采用者急于参加CMS创新中心计划，而其他提供商没有，相信美国医院协会和其他市场利益集团将成功地游说违背一些基于绩效的市场激励措施。现在，在2018年，与8年前相比，政策不确定性和市场不确定性。考虑到减少入院和可避免的医院使用，尽管学术界中的争议充满活力，但政策已经非常一致！交付系统的进展情况在明确的过渡中，远离服务费用和基于价值的付款，越来越多的负责任的关怀组织，基于价值的合同参与者以及数百万患者根据这些新安排管理。大多数健康系统领导者都知道我们正在向替代支付模式的明确路径奖励价值而不是卷。

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