"看起来相似"的双重资格特殊需求计划的快速招生增长:对综合护理的威胁
Yanlei Ma1, Austin B Frakt2, Eric T Roberts3
1Yanlei Ma, Harvard University, Boston, Massachusetts.
Health affairs (Project Hope)
|July 5, 2023
概括
双重符合条件的特殊需求计划 (D-SNP) 旨在整合医疗保险和医疗补助. 然而",相似"的计划正在迅速招收双重资格者,可能会破坏弱势群体的护理整合努力.
科学领域:
- 卫生政策 卫生政策
- 医疗保健管理的管理
- 公共卫生 公共卫生
背景情况:
- 政策制定者正在优先考虑医疗保险和医疗补助的整合,以满足双重资格的个人.
- 双重符合条件的特殊需求计划 (D-SNP) 是这种整合的关键策略.
- 一个新的问题涉及"相似"的计划,这些计划注册了没有综合服务的双重资格.
研究的目的:
- 分析D-SNP类似计划的全国招生趋势.
- 描述这些计划中注册的双重符合条件的个人.
- 评估相似计划对护理整合努力的影响.
主要方法:
- 对2013-2020年全国入学数据的分析.
- 与传统的D-SNP相比,D-SNP类似计划的入学趋势的比较.
- 检查注册双重资格人的人口和先前计划特征.
主要成果:
- 在2013年至2020年期间,类似计划的入学人数增加了11倍,从4个州扩大到17个州.
- 到2020年,超过20万名双重符合条件的人被纳入了类似计划.
- 几乎三分之一的双重符合条件的人在相似计划中以前参加过综合护理计划.
- 相似计划与D-SNP相比,不成比例地招募了老年人,西班牙裔和社会经济不利的双重资格者.
结论:
- 与D-SNP相似的计划正在快速增长,并注册了大量的双重资格者.
- 这些计划可能对国家整合医疗保险和医疗补助服务的目标构成威胁.
- 易受伤害的双重资格子组,他们可以从综合护理中获益最多,越来越多地注册非综合的类似计划.
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