医疗补助支出在协调-只有双重-有资格的特殊需要计划
Neto Coulibaly1, Kelley A Jones2, Valerie A Smith2,3,4,5
1Brown University School of Public Health, Brown University, Providence, Rhode Island.
JAMA network open
|January 22, 2025
概括
只有协调的双重资格特殊需求计划 (D-SNP) 维持了医疗补助计划的长期服务和支持支出. 可能需要更高的整合来减少这些受益人的养老院过渡.
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
- 老年学是一门学科.
背景情况:
- 超过400万的医疗保险受益人加入了双重资格的特殊需求计划 (D-SNP).
- 只有协调性的D-SNP是常见的,但它们对医疗补助服务和支出,特别是长期服务和支持 (LTSS) 的影响尚不清楚.
- 医疗补助是LTSS的主要支付人,因此对这些服务的D-SNP影响至关重要.
研究的目的:
- 评估与非D-SNP医疗保险优势 (MA) 计划相比,在仅协调D-SNP计划注册之前和注册后的Medicaid服务费 (FFS) 支出变化.
- 分析社区生活的双重资格受益人对各种医疗补助覆盖服务的影响,包括LTSS.
- 为有关D-SNP整合及其对弱势群体的影响的政策提供信息.
主要方法:
- 使用新用户,主动比较器设计的队列研究,治疗权重的逆概率.
- 包括北卡罗来纳州社区生活的双重符合条件的受益者,他们先前在医疗保险FFS注册.
- 对2014-2017年医疗保险和北卡罗来纳州医疗补助申请数据的分析,以比较在MA入学前和后的支出模式.
主要成果:
- 在D-SNP和其他MA计划组之间,没有观察到D-SNP和其他MA计划组在注册后的Medicaid FFS每人/年总体支出方面的显著差异.
- 与其他MA组相比,D-SNP组的社区个人护理服务 (LTSS的组成部分) 支出大幅增加.
- 这使得D-SNP队列中的LTSS支出保持不变,与对照组中观察到的减少形成鲜明对比.
结论:
- 只有协调的D-SNP与医疗补助 (Medicaid) FFS对LTSS,特别是社区个人护理服务的持续支出有关.
- 尽管如此,目前在仅协调D-SNP中的整合水平可能不足以显著减少或延迟养老院过渡.
- 进一步研究D-SNP中更高的整合模式是有必要的,以优化LTSS交付和双重资格的个人的结果.
更多相关视频
06:55Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
14.4K
07:20Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
1.0K
相关概念视频
Specialized Care Centers and Settings-II
700
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
700
Specialized Care Centers and Settings-I
915
Specialized care settings or centers are situated in convenient locations within the community and offer care to a specific group or population. They consist of daycare facilities, mental health facilities, rural health facilities, educational institutions, industries, shelters for the homeless, and rehabilitation facilities.
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
915
Planning Nursing Care I
4.3K
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
4.3K
Documentation in Long-Term and Home Healthcare Setting
871
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
871
Standards of Care I
668
Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
668
Planning Nursing Care II
2.5K
A nursing care plan can present in two forms: informal and formal. Informal is a care plan for the individual use of the nurse and goals they wish to accomplish during their shift. Informal care plans are not included in the patient chart. A formal nursing care plan is a written or computerized guide that organizes patient care. It is further subdivided into two: standardized and individualized care plans. Standardized care plans are pre-populated care plans for specific patient populations,...
2.5K
