在Medicare Advantage中补充福利的水平和组成的趋势
1Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA 90089, United States.
Health affairs scholar
|May 17, 2024
概括
医疗保险优势计划越来越多地使用折扣用于牙科,视力和听力等补充福利. 然而,受益人面临更高的自费费用和D部分扣除额,这影响了医疗保健的整体负担能力.
科学领域:
- 卫生政策 卫生政策
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 医疗保险优势 (MA) 计划在投标低于基准时获得折扣.
- 这些折扣必须通过额外的福利或成本削减返还给受益人.
- 了解退款增长和福利变化对于MA政策评估至关重要.
研究的目的:
- 评估2011-2022年医疗保险优惠折扣的增长情况.
- 分析补充福利组合的变化,以及折扣的增长.
- 评估对受益人成本和成本共享的影响.
主要方法:
- 使用的医疗保险和医疗补助服务中心数据.
- 对HMO和PPO (2011-2022) 的MA折扣的分析趋势.
- 检查了补充福利 (牙科,视力,听力) 和成本共享结构的变化.
主要成果:
- 平均MA折扣大幅增加,特别是在2015年后和PPO.
- 到2022年,对牙科,视力和听力福利的覆盖几乎成为普遍的.
- 计划降低了D部分保险费,但增加了自扣额,自付的最高额度和住院费用共享.
结论:
- 医疗保险优势退款的增长与扩展的补充福利有关.
- 受益人通过更高的成本共享和自扣额度而增加了财务风险.
- 这些发现与正在进行的医疗保险优势支付政策改革有关.
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