美国维持急诊医疗服务的策略.pdf

1、Strategies for Sustaining Emergency Care in the United States1RAND proprietary not to be distributedJuly 9,2025Mahshid Abir,MDCarl Berdahl,MD,MS,FACEP3.PAYMENT24.FUNDING STRATEGIES(tied to value)2.CHALLENGES1.VALUE1.EDs provide value to a variety of stakeholdersSociety and their Government Represent

2、ativesPayersPatientsHealth SystemsCare access and safety netCare for service-intensive populationsCommunity resilienceAdvanced diagnosis and treatmentPreservation of inpatient capacityCare coordinationCare innovationNational securityPublic healthImproved health outcomes and potential cost savings th

3、rough timely care and averted hospitalizationsTimely and comprehensive accessReduced barriers to care(financial or bureaucratic)Increasing care complexity,acuity,and boarding/crowdingExpanding scope of workCompeting stakeholder expectations(throughput,complexity,patient experience)Increase in uncomp

4、ensated and undercompensated careUnderpayment by insurance administrators and patientsDecreasing payments to ED professionals2.We summarized the evidence on key challenges that EDs faceWorkforce challenges3.We found that payments to ED professionals are decreasing over timeMedicaidMedicaidMedicareCo

5、mmercial In-NetworkCommercial Out-of-Network20182019202020212022110100908070605040Index,2018=100(Meanwhile,facility payments are increasing!)4.A tiered strategy for payment can address challenges and enable EDs to continue to provide valueTier 3bTier 3aTier 2Tier 17RAND proprietary not to be distributedMahshid Abir:mabirrand.orgCarl Berdahl:cberdahlrand.org Thanks to all of you!