メディケアの料金表が医師への支払いに与える影響
J M Levy1, M J Borowitz, S F Jencks
1Office of Research, Health Care Financing Administration, Baltimore, MD 21207.
JAMA
|August 8, 1990
まとめ
Medicare Fee Scheduleは,医療費を専門分野と地域間で大幅に再分配し,資源ベースの相対価値スケールの作業値ではなく,地理的調整が主なドライバーとなります.
科学分野:
- 健康経済学 医療経済学
- 保健医療政策について
- メディカル・プラクティス・マネジメント・マネジメント
背景:
- メディケアプログラムは1992年にメディケア料金表に移行しました.
- このスケジュールは,地理的に調整された標準化された支払い率を使用しています.
- それは,資源ベースの相対価値スケール (RBVS) と現在のメディケア支払いに基づいています.
研究 の 目的:
- メディケア料金表が支払いの再分配に与える影響をシミュレートする.
- 医学専門分野と地理的地域における影響を分析する.
- 支払いの再分配の主な原動力を決定する.
主な方法:
- メディケア料金表のシミュレーションモデリング.
- 専門分野間の支払い再分配の分析.
- 支払いの影響における地理的変動の評価.
- 専門分野内での提供者効果の評価.
主要な成果:
- メディケア支給の特異分野間での再分配は,予想より少なかったが,実質的であった.
- 重要な地理的再分配が発生し,専門レベルでの影響が加わります.
- 支給効果の大きな差異は,個々の医学専門分野内で発見されました.
結論:
- メディケア料金表の地理的調整要素は,支払いの再分配の主な原動力である.
- 資源ベースの相対価値スケールの作業値は,地理的調整よりも少ない影響を持っています.
- 料金表の導入は,プロバイダーに複雑で多様な影響を及ぼしました.
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