纽约平衡计费条例对地面救护车定价的影响
Wendy Y Xu1, Christopher Garmon2, Sheldon M Retchin3
1Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, USA.
Health services research
|October 17, 2024
概括
纽约对地面救护车的意外收费法提高了13%的价格,网络内和网络外服务的成本更高. 这项旨在保护患者的立法可能会无意中增加整体医疗保健费用.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 紧急医疗服务 紧急医疗服务
背景情况:
- 紧急地面救护车是患者意外医疗账单的重要来源.
- 2020年联邦"无惊喜法"将紧急地面救护车服务排除在其保护范围之外.
- 一些州已经实施了法规,以保护患者免受地面救护车服务的网络之外的余额计费.
研究的目的:
- 评估纽约意外计费法规对紧急地面救护车提供商定价策略的影响.
- 确定国家一级关于地面救护车余额计费的规定是否导致价格变化.
- 评估对自我资助的健康计划的潜在溢出影响.
主要方法:
- 在2012-2019年商业索赔数据上使用差异差异设计与随机推断 (RI).
- 分析了纽约2015年3月的法律,该法律将网络外 (OON) 退款与通常,习惯性和合理的费率挂.
- 将纽约的价格变化与没有惊喜计费法律的类似州进行比较,包括对自我资助计划的检查.
主要成果:
- 纽约的法律与对照状态相比,紧急地面救护车总价格上了13% (RI p值:0.07).
- 完全保险计划的网络内价格上了21%,OON价格上了19% (两者的RI p值为0.07).
- 自保计划的整体和网络价格均出现了类似的价格上;在自保计划中,没有发现自付成本共享的重大变化.
结论:
- 纽约的意外收费法规,以收费为基础的报销,可能会导致紧急地面救护车服务的价格上.
- 旨在保护患者免受地面救护车运输意外费用的立法可能会产生意想不到的后果,导致医疗保健成本上升.
- 这项研究提供了关于此类法规对地面救护车提供者的价格影响的第一个经验证据,突出了对完全保险和自筹计划的潜在影响.
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