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市場調查報告書

美國的價值為基礎償付的轉變

Value-based Reimbursement Transition in the US

出版商 Frost & Sullivan 商品編碼 346631
出版日期 內容資訊 英文 54 Pages
商品交期: 最快1-2個工作天內
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美國的價值為基礎償付的轉變 Value-based Reimbursement Transition in the US
出版日期: 2015年12月11日 內容資訊: 英文 54 Pages
簡介

美國的醫療產業,持續大幅度轉移到價值為基礎照護,影響全部相關利益者。Centers for Medicare and Medicaid Services (CMS) ,構築影響醫療服務的全部償付的政策與替代性付款模式,促進轉移。

本報告提供美國的償付趨勢CMS的該轉移相關2018年的目標與其到達目標的途徑、對醫護人員和醫生等的影響、醫療供應商的創新經營模式等相關資料、案例研究彙整。

摘要整理

背景

  • 背景
  • 價值的補償階段
  • CMS發表的價值為基礎照護的目的
  • CMS轉移到目標付款

醫護人員的依據效能付款

  • 類別2
  • 降低再住院
  • 價值為基礎的購買:對傳統供應商的影響
  • 2015年度的影響

醫生的效能為基礎付款

  • 類別2
  • 價值為基礎修正因素:對醫生的影響
  • 價值為基礎修正因素:2016年、2017年的影響
  • EHR的有價值的使用

替代性付款模式

  • 類別3及4
  • 有責任的照護組織的趨勢
  • CMS設立了的ACO
  • 類別3及的4:其他APM

其他的HHS活動

  • 影響醫療相關利益者的其他活動
  • 醫療供應商的影響

醫療用IT的風險共享價格設定模式

  • Health Catalyst的Pop 跟Health的風險共享契約
  • Health Catalyst的風險共享經營模式的案例
  • athenahealth
  • Sanitas

國民健康管理

  • 作為VBR中心的國民健康管理對供應商來說是困難的業務
  • Health CatalystTexas Children 適合Hospital主導7,400萬美元的業務效率化計劃
  • Catholic Health Partners轉移到PCMH,透過Explorys的PHM平台在成功背面達成ACO

結論

  • 摘要
  • 結論
  • 法律上的免責聲明

附錄

Frost & SUllican案例

目錄
Product Code: 9AB9-00-44-00-00

Market Due Diligence and Strategy Considerations

The US healthcare industry is undergoing a major transition toward value-based care, affecting all its stakeholders. Centers for Medicare and Medicaid Services (CMS) are steering this transition by developing policies and alternative payment models that affect all reimbursements for healthcare services. This document provides insight into CMS's 2018 goals for this transition, the pathway adopted to achieve those goals, and current progress towards achieving these goals. Financial performance of various industry stakeholders including physicians, providers, and the Accountable Care Organizations as well as anticipated short term trends for the CMS implemented programs are highlighted. The document includes case studies that throw light upon innovative business models designed by healthcare vendors that support providers undergoing this transition.

Table of Contents

1. VALUE-BASED REIMBURSEMENT TRANSITION IN THE US

Executive Summary

  • 1. Research Scope
  • 2. Key Questions Addressed
  • 3. CEO's Perspective

Background

  • 1. Background
  • 2. Tiers of Value-Derived Compensation
  • 3. CMS-Announced Value-Based Care Goals
  • 4. CMS Targeted Payment Transition

Pay-for-Performance Providers

  • 1. Category 2-P4P for Providers
  • 2. Re-admissions Reduction-Provider Impact
  • 3. Value-Based Purchasing-Historical Provider Impact
  • 4. Value-Based Purchasing-FY 2015 Provider Impact

Pay-for-Performance Physicians

  • 1. Category 2-P4P for Physicians
  • 2. Value-Based Modifier-Physician Impact
  • 3. Value-Based Modifier-CY 2016, 2017 Physician Impact
  • 4. EHR Meaningful Use-Physician Impact

Alternative Payment Models

  • 1. Categories 3 & 4-Alternative Payment Models
  • 2. Accountable Care Organizations Landscape
  • 3. CMS Established ACOs
  • 4. CMS Established ACOs (continued)
  • 5. Categories 3 & 4-Other APMs

Other HHS Activities

  • 1. Other Activities Impacting Healthcare Stakeholders
  • 2. Impact on Healthcare Vendors

Risk Sharing Pricing Models in Health IT

  • 1. Health Catalyst Risk-Sharing Contract in Pop Health
  • 2. Health Catalyst Risk-Sharing Business Model Example
  • 3. athenahealth
  • 4. Sanitas

Population Health Management

  • 1. Population Health Management, Central to VBR, is Difficult Business for Providers
  • 2. Health Catalyst Led Operational Efficiency Program Yielded Benefits Worth $74 Million for Texas Children Hospital
  • 3. Catholic Health Partners Transitioned to PCMH & Achieved ACO Success through Explorys' PHM Platform

Conclusion

  • 1. Summary
  • 2. Conclusion
  • 3. Legal Disclaimer

Appendix

  • 1. Abbreviations
  • 2. Hospital Value Based Purchasing Program- Parameter Weightage

The Frost & Sullivan Story

  • 1. The Frost & Sullivan Story
  • 2. Value Proposition-Future of Your Company & Career
  • 3. Global Perspective
  • 4. Industry Convergence
  • 5. 360° Research Perspective
  • 6. Implementation Excellence
  • 7. Our Blue Ocean Strategy
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