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农村地区的医疗保险优势:对医院可持续性的影响
Rachel Mosher Henke, Kathryn R Fingar, Lan Liang
1Agency for Healthcare Research and Quality, 5600 Fishers Ln, Rockville, MD 20857.
The American journal of managed care
|November 10, 2023
概括
农村地区的Medicare Advantage计划与改善医院财务状况和降低关闭风险有关. 增加计划透率与这些设施的财务稳定性更大相关.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 农村卫生政策 农村卫生政策
- 医疗保健经济学 医疗保健经济学
背景情况:
- 医疗保险优势 (MA) 招生在农村受益者中正在增加.
- 马计划谈判医院补偿费率,影响农村医院的财政.
- 了解MA透的财务影响对于农村医疗保健的可持续性至关重要.
研究的目的:
- 检查医疗保险优势透率和农村医院的财务困境之间的联系.
- 评估MA透对农村医院关闭风险的影响.
主要方法:
- 农村一般急症护理医院的回顾性队列研究 (2008-2019).
- 使用的医疗保健成本和利用项目来自14个州的州住院患者数据库.
- 分析了医疗保险优势透率 (医院和县级),使用财务困境的Altman Z分数和关闭风险的Cox比例危险模型.
主要成果:
- 农村医院的MA透率从6.5% (2008) 增加到20.6% (2019).
- 医院MA透率增加1%与阿尔特曼Z分数增加0.04个单位相关 (表明金融稳定性有所改善).
- 医院MA透率每增加1%都与关闭风险减少4%有关.
结论:
- 这些发现挑战了Medicare Advantage计划对农村医院财政产生负面影响的假设.
- 增加医疗保险优势透率似乎提高了金融稳定性,并降低了农村医院关闭风险.
- 这表明Medicare Advantage和农村医疗保健提供者之间可能存在有利的财务关系.
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