2013年至2017年期间医疗保险优势提供者网络限制性和星级评级之间没有关联:一项观察性研究
Dannie Dai1, Yevgeniy Feyman2, Jose F Figueroa1,3
1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Journal of general internal medicine
|July 19, 2024
概括
医疗保险优势的质量评级并不反映提供者网络的限制性. 受益人可能需要更具体的指标来选择计划,提供他们重视的供应商选择.
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:
- 医疗保险优势 (MA) 注册人数正在增加,计划使用提供商网络限制.
- 受益人重视供应商选择,但目前的MA质量指标可能不表明网络限制性.
研究的目的:
- 评估医疗保险优势提供者网络限制性和合同星级等级之间的关联.
- 评估网络限制性和获得护理措施之间的关系.
主要方法:
- 对2013-2017年期间的医疗保险优势合同 (HMO,PPO,POS) 的横截面分析.
- 多变量线性回归用于检查网络限制性和质量得分之间的关系.
主要成果:
- 在供应商网络限制性和MA合同星级评级之间没有发现一致的关系.
- 网络限制性并不总是与获得护理措施的表现相关.
结论:
- 目前的Medicare Advantage质量指标并不能有效地表明提供者网络限制性的差异.
- 需要更具体的质量指标,以帮助受益人做出明智的选择,以了解在授权计划中的提供者访问.
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