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Issues And Trends In Healthcare Delivery System01:29

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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.
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相关实验视频

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Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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在医疗保险优势中编码强度的变化

Vilsa E Curto1, Eran Politzer2, Timothy S Anderson3

  • 1Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, United States.

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概括
此摘要是机器生成的。

医疗保险优势计划激励强烈的诊断编码,导致显著的编码通货膨胀. 一种使用死亡率的新方法发现,平均通货膨胀率为8.4%,影响了大多数入学者.

关键词:
医疗保险优势是什么编码强度的编码强度上升编码的 上升编码.

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科学领域:

  • 卫生经济学 卫生经济学
  • 卫生政策 卫生政策
  • 生物统计学 生物统计学

背景情况:

  • 医疗保险优势 (MA) 注册人数超过50%的符合条件的受益人.
  • 许可证支付依赖于基于前一年诊断的风险评分,为密集编码创造激励.
  • 评估编码强度的现有方法存在局限性.

研究的目的:

  • 用一种新的方法估计单个MA合同的编码通胀率.
  • 分析与MA计划中更高编码强度相关的因素.
  • 评估超过医疗保险调整的编码通货膨胀的流行情况.

主要方法:

  • 开发了一种使用计划级死亡率推断编码强度的新方法.
  • 将该方法应用于2014年医疗保险优势风险评分和健康状况数据.
  • 分析了不同MA合约特征的编码通货膨胀率.

主要成果:

  • 2014年注册人数加权平均编码通胀率为8.4%.
  • 编码通货膨胀率在MA保险公司和合同之间有很大差异.
  • 更高的编码强度与HMO,提供商拥有的计划,更大/更老的计划以及高星级的计划有关.
  • 68.1%的注册医疗保险人有合同,其代码的通胀率超过了医疗保险的调整.

结论:

  • 在医疗保险优势计划中存在显著的编码通胀.
  • 这种新方法提供了一种可靠的方式来评估编码强度.
  • 编码通货膨胀影响了大多数医疗保险优势计划的注册人,可能会影响计划的完整性.