在计划支付减少后,医疗保险优势的增长
Aaron L Schwartz1,2,3, Seyoun Kim4, Amol S Navathe1,2,3
1Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
由于"平价医疗法案" (ACA) 削减了医疗保险优势 (MA) 支付,但这并没有减少受益者入学率. 这项研究表明,尽管支付减少,但MA访问仍然稳定.
科学领域:
- 卫生政策 卫生政策
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 政策建议建议减少联邦对医疗保险优势 (MA) 计划的支付.
- 这些支付削减对受益人获得许可证的影响仍然不清楚.
研究的目的:
- 量化根据"可负担医疗法案" (ACA) 减少MA支付与MA入学人数增长之间的关联.
- 评估ACA授权削减对MA基准支付率和随后的入学的影响.
主要方法:
- 从2008年到2019年使用县级入学和支付数据的回顾性队列研究.
- 差异分析分析,比较在ACA之前和之后,较大比较较小的基准支付减少的县的MA入学变化.
主要成果:
- 由ACA引发的基准支付削减在各县有很大差异 (平均为5.9%).
- 在ACA后较大或较小的基准削减县之间没有观察到MA入学率的差异变化 (P=.98).
- 每个会员每月的计划支付在具有较大基准削减 (减少78.35美元;P<.001) 的县里显著下降.
结论:
- 没有证据表明ACA支付削减损害了受益人获得医疗保险优势的机会.
- 调查结果支持正在进行的关于MA支付水平和医疗保险改革的政策讨论.
- 这项研究表明,MA招生对基准支付削减具有弹性.
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