Legal reforms necessary to promote delivery system innovation.

摘要

To improve the quality of care and restrain costs require coordinated care, including a reimbursement system that facilitates such coordination. However, the optimal way to organize care and pay clinicians is unknown. A variety of alternatives are being tried. For instance, Shortell and Casalino8 have described 5 different models of "accountable care systems" with varying degrees of clinical, administrative, and financial integration. Similarly, trials of pay-for-performance, bundled payments, partial capitation, and other payment systems are ongoing. The United States needs a continuous process of experimentation with organizational and payment innovations to provide high-quality care at appropriate costs.