新墨西哥州"无行为健康成本共享法"的实施:一项定性研究
Samantha J Harris1, Ezra Golberstein2, Johanna Catherine Maclean3
1Samantha J. Harris (samanthaharris@jhu.edu), Johns Hopkins University, Baltimore, Maryland.
Health affairs (Project Hope)
|October 7, 2024
概括
新墨西哥州的新墨西哥州
科学领域:
- 卫生政策 卫生政策
- 行为健康 行为健康
- 医疗保健经济学 医疗经济学
背景情况:
- 出自口袋的支出对私人保险人员获得医疗保健构成了重大障碍.
- 行为健康治疗往往会导致大量的患者成本共享,限制了获取.
- 新墨西哥州在2022年颁布了一项具有里程碑意义的法律,以消除行为健康服务的成本共享.
研究的目的:
- 评估新墨西哥州"无行为健康成本共享法"的实施和所感知的影响.
- 探索法律如何影响患者获得护理和经济负担.
- 确定潜在的挑战和促进者,以实现更广泛的采用.
主要方法:
- 涉及关键信息者的定性研究:临床医生,保险公司和国家官员.
- 探索有关法律实施,支出影响和获得护理的看法.
- 分析利益相关者的担忧,包括劳动力能力和监管豁免.
主要成果:
- 该法被普遍看作是有利的,并顺利实施,对密集治疗的准入产生了积极的影响.
- 临床医生对劳动力短缺和自我保险计划 (ERISA豁免) 的排除表示担忧.
- 保险公司指出,由于欺诈或废物监控,造成的行政负担和可能增加的保费.
结论:
- 新墨西哥州的法律是通过消除成本障碍来改善行为健康准入的潜在模式.
- 实施成功取决于解决劳动力局限性,提高成员意识,以及导航联邦ERISA法规.
- 需要进一步的策略,以确保所有个人,无论其保险计划类型,均可获得公平的机会.
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