在医疗保险优势计划中的累积退学趋势,2011-2020年
David J Meyers1, Andrew M Ryan1, Amal N Trivedi1
1Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
JAMA health forum
|August 25, 2023
概括
退出医疗保险优势 (MA) 的比例很高,近一半的受益者在5年内退出计划. 长期退学因计划质量和受益人特征而有很大差异,这凸显了需要更好的绩效措施的需要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 老年学是一门学科.
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗保险优势 (MA) 计划正在经历显著增长.
- 之前的研究表明,在有更大的健康需求的受益者中,退学率更高.
- 士课程中的长期退学趋势仍然未得到充分探索.
研究的目的:
- 为了比较MA课程中累积的退学趋势.
- 根据受益者和计划特征分析退学模式.
主要方法:
- 追溯的,连续的横截面研究设计.
- 从2011年到2020年,将受益人纳入MA招生.
- 分析受益人的人口统计数据,入学历史,健康状况和合同特征.
主要成果:
- 在五年内,非双重登记者的累计退学率达到48.3%,双重资格受益者的累计退学率达到53.4%.
- 黑人登记者表现出最高的退学率 (52.6%在5年后).
- 与评级较低的计划相比,五星级的MA计划显示了相对较低的五年退学率 (23.0%).
结论:
- 从MA计划中大量的累积退出发生在五年内,在合同之间存在很大的差异.
- 一年退学率与五年退学率没有很强的相关性,这表明使用短期措施的局限性.
- 评估长期退学对于MA绩效测量至关重要,以获得更完整的计划稳定性和受益人保留的图片.
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