医疗系统的扩张和医疗保险的变化 医疗保险的受益者 使用安全网提供商
Kun Li1,2,3, José J Escarce4, Shiyuan Zhang1
1RAND, Arlington, VA.
Medical care
|December 6, 2024
概括
垂直整合的卫生系统正在导致医疗保险患者离开联邦合格卫生中心 (FQHC). 这种扩张导致FQHC访问和患者减少,影响安全网提供商.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
背景情况:
- 关于保险患者如何利用安全网提供商的证据有限,因为美国垂直整合卫生系统的增长.
- 联邦合格卫生中心 (FQHCs) 作为关键的安全网提供者,特别是对于低收入和弱势群体.
研究的目的:
- 调查市场级卫生系统透率与医疗保险受益人从FQHC到卫生系统的初级保健来源的转移之间的联系.
- 评估卫生系统扩张对FQHCs医疗保险患者数量和访问频率的影响.
主要方法:
- 使用的医疗保险服务费索赔数据从2013年到2018年.
- 采用受益人级别的离散时间生存分析和市场级别的线性回归.
- 分析了来自27386个初级保健市场的659652名医疗保险受益人的数据.
主要成果:
- 观察到Medicare FQHC患者转换到卫生系统的概率增加了4.6个百分点,随着卫生系统透率的增加.
- 医疗系统透率的增加与医疗保险FQHC访问减少22次,每市场年分配的受益人减少4人相关.
- 患有复杂健康需求的患者和来自非FQHC独立医生组织的患者显示更高的转换率到卫生系统.
结论:
- 医疗系统的扩张与FQHCs医疗保险患者数量的下降有关.
- 这些发现表明,垂直整合对FQHC等独立安全网提供商可能会产生不利影响.
- 需要考虑政策考虑,以减轻卫生系统增长对弱势群体获得护理的影响.
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