医疗保险优势四分位数调整系统与计划行为和招生之间的关联
Roslyn C Murray1, David J Meyers2, Erin C Fuse Brown3
1University of Michigan, Ann Arbor.
JAMA health forum
|January 12, 2024
概括
医疗保险优势 (MA) 保险公司对付款率变化没有高度敏感. 调整四分位数调整系统可以节省资金,而不会显著影响MA受益者或计划供应.
科学领域:
- 卫生经济学 卫生经济学
- 卫生政策 卫生政策
- 医疗保险优势是什么
背景情况:
- 医疗保险优势 (MA) 计划越来越受欢迎,但人们担心由于四分位数调整系统而导致保险公司过度支付.
- 消除四分位数调整可能会减少福利和计划选择,可能会减缓MA招生.
研究的目的:
- 调查四分位数调整系统与县级福利,保险公司产品和MA招生之间的关联.
- 为了确定修改四分位数调整系统是否会影响MA计划特征和招生.
主要方法:
- 利用回归不连续性设计分析了2017年1月至2021年12月的数据.
- 检查了1557个县的观察结果,以评估保险公司行为的变化和根据历史医疗保险支出进行的四分位数调整的MA入学率.
主要成果:
- 四分位数调整的1%增加与较高的基准标准 (6.36美元) 和较低的保费 (减少0.51美元) 相相关.
- 在初级保健共同支付,B部分保费折扣,补充福利,计划/合同可用性或MA入学率方面没有观察到重大变化.
- 收取保费的计划的份额下降了0.68个百分点,四分位数调整增加了1%.
结论:
- 医疗保险优势计划对支付费率的适度变化敏感度较低.
- 对四分位数调整系统的修改可能会提供潜在的节省,而不会显著改变MA福利或入学率.
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