超过平均支出:分配和季节性商业保险趋势,2012-2021年
Erin L Duffy1, Sarah Green, Samantha Randall
1Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, 635 Downey Way, VPD 414F, Los Angeles, CA 90089-3333.
The American journal of managed care
|September 20, 2024
概括
年平均支出掩盖了患者自付费用. 这项研究揭示了医疗保险支出分配和季节性的变化,突出了患者成本共享和交叉补贴的增加.
科学领域:
- 卫生经济学 卫生经济学
- 医疗服务研究 医疗服务研究
- 保险和患者融资服务.
背景情况:
- 传统的年度平均支出指标掩盖了医疗保健负担能力的关键分布和季节性变化.
- 这些变化显著影响患者的财务体验和提供者收入周期.
研究的目的:
- 分析医疗保险计划的分配和季节性以及患者自付支出的变化.
- 通过使用商业索赔数据,研究从2012年到2021年的趋势.
主要方法:
- 对多层商业索赔数据的分析.
- 计算每个入学者的医疗费用,包括计划和自付费.
- 根据年度医疗开支的分位数对入学者的分层划分,并根据分位数和季度计算平均开支.
主要成果:
- 经通货膨胀调整后的医疗支出增长最快的是支出的最高人群,但他们的自付费用并没有相应地增加.
- 大多数入学者在COVID-19大流行之前经历了增加的自付支出 (以实际美元和总成本的份额).
- 出口支出集中在日历年初的几个月,由自扣额驱动,在2020-2021年显著下降.
结论:
- 医疗保险有效地保护高消费者,可能减少对其他人的覆盖慷慨.
- 通过成本共享设计而不是保费增加交叉补贴是一个越来越令人担忧的问题.
- 这一趋势值得关注,因为公众对不足保险和医疗债务的担忧日益增加.
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