Paying for Outcomes, Not Performance: Lessons from the Medicare Inpatient Prospective Payment System

摘要

The three interrelated goals of the Affordable Care Act (ACA) of 2010 are to improve access, improve quality, and contain the costs of health care in the United States.1 Without cost containment, neither expansion of access to the uninsured nor continued coverage to those already insured will be sustainable. Inpatient hospital care is the largest single component of health care costs. In this article, we propose principles that can provide the foundation for a practical and effective outcomes-based payment system reform of the inpatient hospital payment system.