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社区卫生工作者服务的医疗补助账单增长,但仍然很低,2016-2020年
Clese Erikson1, Hong-Lun Tiunn1, Jordan Herring1
1The Mullan Institute for Health Workforce Equity, Department of Health Policy and Management, The Milken Institute for Public Health, The George Washington University, 2175K Street, NW, Suite 250, Washington, DC 20037, United States.
Health affairs scholar
|January 15, 2025
概括
社区卫生工作者 (CHWs) 的医疗补助账单显著增长,从2016年到2020年增加了638%. 然而,整体计费仍然很低,俄俄州主导医疗补助受益人参与CHW服务.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 医疗保健管理部门的管理.
背景情况:
- 社区卫生工作者对于改善健康结果至关重要.
- 将CHW整合到医疗补助服务中存在持续的挑战.
- 了解医疗补助计划内的CHW服务利用对于政策制定至关重要.
研究的目的:
- 分析2016年至2020年各州医疗补助服务社区卫生工作者 (CHW) 计费的趋势.
- 为了识别受益人服务的模式,提供的服务,支付类型和用于CHW计费的程序代码.
- 评估CHW融入医疗补助支付系统的整体情况.
主要方法:
- 改造医疗补助统计信息系统 (T-MSIS) 分析文件 (TAF) 2016-2020年数据的探索性描述性分析.
- 对CHW服务的直接计费趋势的检查.
- 分析包括受益者,服务,支付类型,服务地点和程序代码.
主要成果:
- 在2016年至2020年期间,医疗补助账单的CHW数量激增了638%.
- 尽管有增长,但到2020年,只有731家医疗保健机构在9个州向医疗补助公司收费,俄俄州占受益人数的77.7%.
- 医疗保健服务增加了近23倍,其中37.7%在患者家中提供;注意到收费不一致.
结论:
- 医疗保健机构的医疗补助账单总体上仍然很低,州一级的差异很大,特别是俄俄州的高利用率.
- 电热水电服务的大幅增长凸显了它们日益增长的作用,但收费挑战仍然存在.
- 调查俄俄州成功的扩张模式为更广泛的CHW整合到医疗补助提供了宝贵的见解.
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