特殊需要计划有多专业? 来自提供商网络的证据
Grace McCormack1, Rachel Wu2, Mark Meiselbach2
1University of Southern California, Los Angeles, USA.
Medical care research and review : MCRR
|November 19, 2024
概括
医疗保险优势 (MA) 双重符合条件的特殊需求计划 (D-SNP) 越来越多地使用专门的提供者网络. 这些网络更好地服务于双重资格的个人,包括更多的专家,如精神病医生和神经病学家.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
- 管理护理管理护理
背景情况:
- 在过去的十年中,Medicare Advantage (MA) 双重符合条件的特殊需求计划 (D-SNP) 的入学人数急剧增加.
- 了解D-SNP计划设计,特别是提供商网络,对于为双重符合条件的个人提供服务至关重要.
研究的目的:
- 分析与标准MA计划相比,D-SNP提供商网络专业化的程度.
- 确定D-SNP网络设计是否符合双重资格的招生人的医疗保健需求.
主要方法:
- 2022年对D-SNP和标准MA计划提供商网络的分析.
- 网络组成的比较,重点是专业人员的包容性.
主要成果:
- 在2022年,46%的D-SNP具有不同于标准MA计划的提供商网络.
- 专门的D-SNP网络显示了精神病学家,妇产科医生和神经病学家的较高度.
- 网络专业化在当地医疗补助市场参与的地区更为普遍,在供应商短缺的地区更少.
结论:
- D-SNP网络的专业化是一个重要的设计特征,它似乎是根据双重资格人群的需求量身定制的.
- 诸如医疗补助市场存在和提供商谈判成本等因素可能会影响采用专门网络.
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