在医疗保险优势登记者中,新的补充福利和计划评级
Emma L Tucher1,2, David J Meyers2,3, Amal N Trivedi2,3,4
1Division of Research, Kaiser Permanente Northern California, Oakland.
JAMA network open
|June 5, 2024
概括
提供慢性病患者特殊补充福利 (SSBCI) 和主要与健康相关的福利 (PHRB) 的医疗保险优势计划在入学计划评级上有轻微改善. 这表明,投资于这些附加福利可以增强会员体验和计划质量.
科学领域:
- 卫生政策 卫生政策
- 医疗保健服务研究 医疗服务研究
- 老年学是一门学科.
背景情况:
- 美国国会在2018年启用了医疗保险优势 (MA) 计划,通过慢性病患者特殊补充福利 (SSBCI) 来解决社会需求.
- 医疗保险和医疗补助服务中心在2019年扩大了主要与健康相关的福利 (PHRB) 以包括非医疗服务,但由于缺乏证据,这种吸收受到限制.
- 评估这些扩展福利对学生满意度的影响对于理解它们的有效性至关重要.
研究的目的:
- 评估医疗保险优势计划采用扩展补充福利 (PHRB和/或SSBCI) 和入学者的满意度之间的关联.
- 为了确定提供非医疗服务是否会影响会员如何评价他们的健康计划.
主要方法:
- 一项队列研究利用了医疗保健提供者的消费者评估和系统调查数据 (2017-2021年) 与行政索赔和福利数据相关联.
- 差异差异估计器比较了MA纳入计划的计划评级,这些计划采用了PHRB,SSBCI或两者兼而有之.
- 分析包括2021年2,558个计划中的388,356个响应,重点关注入学计划评级 (0-10级).
主要成果:
- 采用PHRB和SSBCI福利的Medicare Advantage计划显示,入学者平均计划评级 (95%CI,0.4-4.0) 增加了0.22个点.
- 仅采用PHRB (调整差异,0.12分) 或仅采用SSBCI (调整差异,0.09分) 与计划评级之间没有发现显著的关联.
- 研究样本包括多样化的MA入学者,平均年龄为74.6岁,57.2%是女性,45.1%报告身体健康或身体健康不佳.
结论:
- 采用扩展的PHRB和SSBCI福利与Medicare Advantage注册计划评级的适度改善有关.
- 这些发现表明,增加对综合补充福利的投资可能与改善会员体验和计划质量相关.
- 需要进一步的研究才能充分了解这些好处的长期影响和最佳实施.
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