来自医疗保险共享储蓄计划的估计储蓄
Andrew M Ryan1, Adam A Markovitz2
1Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island.
JAMA health forum
|December 15, 2023
概括
医疗保险共享储蓄计划 (MSSP) 在传统医疗保险中出现损失,但在医疗保险优势中节省,导致CMS的整体净储蓄. 它的总预算影响仍然不确定.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 医疗保险研究研究
背景情况:
- 医疗保险共享储蓄计划 (MSSP) 是CMS的一个关键的替代支付模式.
- 了解MSSP的预算影响至关重要,但尚未确立.
研究的目的:
- 评估MSSP与CMS的净储蓄之间的关联.
- 分析2013年至2021年的业绩表现对预算的影响.
主要方法:
- 使用公开报告的MSSP数据 (2012-2021) 进行经济评估.
- 结合了两项关于传统医疗保险支出的先前研究的估计.
- 通过分析基准支付影响,估计对Medicare Advantage (MA) 的溢出影响.
主要成果:
- 在传统医疗保险中,MSSP与5.84亿美元至1.423亿美元的净损失有关.
- 由于MA基准降低,MSSP节省了4480亿美元至4923亿美元.
- 总体而言,CMS的净储蓄从3.057亿美元到4.339亿美元 (合并支出的0.075%).
结论:
- MSSP导致传统医疗保险的净损失和MA的净储蓄.
- 观察到CMS的整体净节约,但总预算影响很小且不确定.
- 估计总支出效应的挑战,特别是最近,导致了不确定性.
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