美国医疗费用支付方式新趋势——基于价值的补偿机制  

The New Trend of Health Insurance Payment in the USA——the Value-based Compensation Mechanism

作　　者：巩晓力 

机构地区：[1]中国太平保险集团总部,香港999077

出　　处：《中国医疗保险》2016年第8期63-65,70,共4页China Health Insurance

摘　　要：美国医疗保险和健康管理领域的控费方式,正从传统的按照服务项目收取医疗费用的体系,逐渐过渡到考虑治疗或预防效果的收费体系,即基于价值的补偿机制(VBR)。以责任制医疗组织(ACO)为代表的新型医疗组织发展迅速,医生和医疗专业人员在医保控费中发挥了更大的作用。这一趋势无论在美国的社会医疗保险还是商业医疗保险中都非常明显。The entire U.S. healthcare industry is gradually changing from traditional fee-for-service payments to value-based reimbursement（VBR）, which emphasizes the quality and the outcome of the services as an opposite to the quantity of services performed. Together with VBR model, newly emerged health care organizations like ACO are growing very fast, where hospitals, doctors, physicians and other medical professionals play greater roles than ever in medical cost control. The trend is obvious in both social and commercial medical insurance system of the USA.

关 键 词：医疗费用 价值 VBR ACO 

分 类 号：F841.684[经济管理—保险]