医疗保险优势计划的星级和入学率之间的关联
Rachel O Reid1, Partha Deb, Benjamin L Howell
1Centers for Medicare & Medicaid Services, Center for Medicare & Medicaid Innovation, Rapid-Cycle Evaluation Group, Baltimore, MD 21244, USA.
JAMA
|January 17, 2013
概括
医疗保险优势星级评级显著影响入学决策. 较高的评级增加了新受益者和转换受益者的入学概率,尽管影响因人口群体而异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
- 消费者行为 消费者行为
背景情况:
- 美国医疗保险和医疗补助服务中心 (CMS) 使用星级评级来反映医疗保险优势 (MA) 计划质量.
- 这些评级旨在帮助受益者做出明智的入学选择.
研究的目的:
- 评估公开报告的MA计划质量评级与受益者入学模式之间的关联.
- 了解MA星级评级如何影响新入学者和改变计划的人的决策.
主要方法:
- 一项横截面研究分析了2011年MA入学数据.
- 包括952,352名首次注册者和322,699名计划转换者.
- 条件逻辑回归模拟了星级和入学率之间的关系,控制受益人和计划特征.
主要成果:
- 在MA评级增加1星与新受益人的入学可能性增加9.5个百分点相关.
- 对于转换受益者来说,一星级的增加与入学可能性增加了4.4个百分点.
- 黑人,农村,低收入和年轻受益者的星级与入学率之间的关联较弱.
结论:
- 医疗保险优势计划的CMS五星级评级系统显然影响了受益人入学决策.
- 质量评级是计划选择的重要因素,影响了初始和随后的入学选择.
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