将通货膨胀因素引入医疗保险医生费用表中的优点和弱点
Michael E Chernew1, Ateev Mehrotra2, Riya D Doshi3
1Michael E. Chernew (Chernew@hcp.med.harvard.edu), Harvard University, Boston, Massachusetts.
Health affairs (Project Hope)
|December 3, 2024
概括
医疗保险医生费用表更新没有自动通货膨胀调整. 基于通货膨胀的部分更新可以维持获得护理的机会,并减缓医疗保健设施的整合.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 医疗保健管理的管理.
背景情况:
- 医疗保险医生费用表 (MPFS) 在没有自动通货膨胀更新的医疗保险费用表中是独一无二的.
- 了解MPFS更新机制的历史背景对于评估潜在修改至关重要.
研究的目的:
- 评估将基于通货膨胀的调整因子纳入MPFS更新公式的优点.
- 通过激励模式分析费用更新对医疗保健准入和设施整合的潜在影响.
主要方法:
- 描述了医生费用表更新系统的历史.
- 采用激励模式来评估费用对获得护理和医疗保健设施整合的影响.
- 审查了有关费用变化对医疗保险获得权的影响的现有证据.
主要成果:
- 虽然过去的费用变化对访问的影响很小,但这可能不会持续下去.
- 门诊机构和医生办公室之间的费用更新差异可能会推动医疗保健整合.
- 目前的证据并不表明医疗保险内部存在接入危机.
结论:
- 一部分的,基于通货膨胀的,全面的更新 (例如,通货膨胀减去1%) 可能会提高未来获得护理的机会.
- 这种方法可能有助于缓解医疗保健设施的整合.
- 实施基于通货膨胀的更新是可行的,并且提供比差异更新等替代方法更好的分配结果.
相关概念视频
Issues And Trends In Healthcare Delivery System
5.6K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.6K
Inhaled Medications
237
Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...
237
Introduction To Health Care Delivery System
2.6K
The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
2.6K
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS): Interferences
386
Inductively coupled plasma–mass spectrometry (ICP–MS) is a highly selective and sensitive technique for accurate elemental analysis. Though the analysis of ICP–MS mass spectra is comparatively straightforward, it is affected by spectroscopic and non-spectroscopic interferences. Spectroscopic interferences arise when the plasma contains ionic species with an m/z value the same as the analyte ion. Spectroscopic interference can be categorized as isobaric, polyatomic ions, and...
386
Methods of Documentation III: PIE
1.3K
Problem-intervention-evaluation (PIE) is a systematic approach to documentation used in healthcare settings for clinical decision-making and patient care planning. It is a structured approach to organizing patient data based on problems, interventions, and evaluations. Here's a breakdown of its key features and considerations:
1.3K
Factors Affecting Drug Distribution: Miscellaneous Factors
266
Drug distribution in the human body is a complex process influenced by various individual factors, including age, pregnancy, obesity, diet, body water composition, pH levels, and specific disease conditions.
Age plays a significant role due to differences in body composition among different age groups. Infants, for instance, have a higher proportion of total body water and lower albumin levels, a protein that binds drugs in the bloodstream. This unique composition in infants enhances the...
Age plays a significant role due to differences in body composition among different age groups. Infants, for instance, have a higher proportion of total body water and lower albumin levels, a protein that binds drugs in the bloodstream. This unique composition in infants enhances the...
266


