医疗保险费用表对医生付款的影响
J M Levy1, M J Borowitz, S F Jencks
1Office of Research, Health Care Financing Administration, Baltimore, MD 21207.
JAMA
|August 8, 1990
概括
医疗保险费用表将在各专业和地理区域之间大幅重新分配支付,地理调整是主要驱动因素,而不是基于资源的相对价值表工作值.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 医疗实践管理 医疗实践管理
背景情况:
- 医疗保险计划在1992年过渡到医疗保险费用表.
- 该计划使用经过地理调整的标准化支付率.
- 它基于基于资源的相对价值表 (RBVS) 和当前的医疗保险支付.
研究的目的:
- 模拟医疗保险费用表对支付再分配的影响.
- 分析跨医学专业和地理区域的影响.
- 确定支付再分配的主要驱动因素.
主要方法:
- 医疗保险费用表的模拟建模.
- 分析跨专业的支付再分配情况.
- 评估支付影响的地理差异.
- 评估专业内提供者的影响.
主要成果:
- 实质性的,但小于预期的,医疗保险支付在专业领域的重新分配被观察到.
- 发生了重大的地理重新分配,加剧了专业层面的影响.
- 在个别医疗专业内,支付效应存在很大差异.
结论:
- 医疗保险费用表的地理调整组成部分是支付再分配的主要驱动因素.
- 基于资源的相对价值量表的工作值的影响比地理调整要小.
- 收费表的实施对提供商产生了复杂而多样化的影响.
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