麻煩英譯中翻譯,要人工的.
Several factors may explain the absence of clear effects of these “pay for performance” reforms on health and costs. First, improvements in particular aspects of care may not translate into overall health improvements, or they may be offset by reduced quality of care or higher costs in dimensions that are not measured well. Second, many of these reforms were implemented only by particular payers (like Medicare or a private insurance plan), and so the overall changes in incentives for providers who receive income from a variety of sources may have been relatively modest. Third, because the pay-for-performance reforms generally affected only some providers of care, effects on overall utilization and costs may have been mitigated. For example, medical home payments support better coordination by primary care providers, but do not directly support better care by specialists or create accountability for lowering overall costs.