在医疗保险优势成本计划注册者中,网络之外的利用和计划选择
1Schaeffer Center for Health Policy & Economics, Price School of Public Policy, University of Southern California, Los Angeles, California, USA.
Health services research
|January 14, 2025
概括
医疗保险优势 (MA) 费用计划注册者经常使用网络之外的护理. 停止这些计划导致高风险个人选择传统医疗保险 (TM),这表明网络限制影响了选择.
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
- 医疗保险政策 医疗保险政策
背景情况:
- 医疗保险优势 (MA) 计划提供了传统医疗保险 (TM) 的替代方案.
- MA 1876 费用计划允许通过TM通过网络之外的护理覆盖.
- 2019年许多MA 1876成本计划的终止,为研究网络影响提供了一个自然实验.
研究的目的:
- 检查Medicare Advantage网络结构如何影响医疗保健利用和入学决策.
- 分析MA 1876年成本计划终止对会员选择的影响.
主要方法:
- 利用2019年MA计划数据来识别已停止的成本计划.
- 雇员管理医疗保险入学和TM索赔数据 (2018-2019).
- 通过回归分析评估了2018年的网络外使用模式和2019年的入学变化.
主要成果:
- 2018年,69%的费用计划入学者在各种专业领域使用了非紧急网络外护理.
- 停用成本计划的登记者在2019年显示了不利的选择.
- 较高的风险分数与注册传统医疗保险的可能性增加了26.35%.
结论:
- 网络之外的高利用率凸显了MA学员对广泛网络访问的价值.
- 停药后的注册模式表明,风险较高的人更喜欢更广泛的网络,选择TM.
- 有限的MA网络可能会导致对传统医疗保险的重大选择行为.
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