商业保险公司市场力量和医疗补助管理护理网络
Jeffrey Marr1, Daniel Polsky1,2, Mark K Meiselbach1
1Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Medical care research and review : MCRR
|April 5, 2024
概括
具有更大的商业市场力量的保险公司提供更广泛的医疗补助管理护理 (MMC) 医生网络. 这表明,商业市场的强度可以改善医疗补助受益人获得护理的机会.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗补助管理护理 (MMC) 招生超过了70%的受益者,使得提供者网络对获得关键.
- 保险公司经常在商业和医疗补助市场运营,具有市场影响力的潜力.
- 了解商业市场力量和医疗补助网络宽度之间的联系对政策至关重要.
研究的目的:
- 调查商业保险公司市场力量与医疗补助管理护理医生网络的广度之间的关系.
- 量化商业市场份额如何影响医疗补助受益人提供服务的可用性.
主要方法:
- 使用链接的国家入学数据和提供商目录数据进行分析.
- 研究了商业保险公司市场力量 (以市场份额衡量) 与医疗补助医生网络规模之间的相关性.
主要成果:
- 具有更大的商业市场力量的保险公司展示了更广泛的医疗补助医生网络.
- 持有30%以上市场份额的保险公司的网络比同一个县没有商业份额的保险公司宽37.3%.
- 在初级保健和各种专业小组中观察到网络扩张,包括OB / GYNs,外科医生,神经病学家和心脏病学家.
结论:
- 商业保险市场的实力积极影响医疗补助管理护理网络的广度.
- 调查结果表明,从商业市场力量到医疗补助受益人获得护理的潜在溢出效应.
- 解决市场集中问题的政策可能会影响人口中很大一部分人获得医疗保健.
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