成功之路对传统医疗保险利用的早期影响
Meiling Ying1, Addison Shay2, John M Hollingsworth3
1Department of Foundations of Medicine, NYU Langone Health, Mineola, New York, USA.
Health services research
|March 14, 2025
概括
与非ACO相比,Pathways to Success计划在ACO的医疗保险支出减少速度较慢. 这主要是由于ACO参与者在住院护理利用率下降的速度较慢.
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:
- 成功之路 (PTS) 计划旨在控制可问责护理组织 (ACO) 内的医疗保健成本.
- 了解PTS对医疗保健利用的早期影响对于评估其有效性至关重要.
研究的目的:
- 评估PTS实施对医疗保健利用的初始影响.
- 为了测量季度价格标准化医疗保险支出每受益人的变化.
主要方法:
- 全国传统医疗保险受益人的回顾性队列分析.
- 比较参与PTS的ACO与非ACO控制的支出.
- 利用了2018年1月至2020年3月的数据,重点关注于2019年7月1日PTS实施后的时期.
主要成果:
- 调整后的季度支出每受益者在ACO下降的速度较为缓慢,而不是控制 (+46.8美元).
- 这一差异主要是由于ACO内的住院护理支出减少速度较慢 (+ 43.6美元).
- 在两组中,未经调整的支出都下降了,但经过调整后的分析显示了差异性的影响.
结论:
- 与非参与者相比,PTS计划中的ACO在实施后的利用率下降速度较慢.
- 在ACO中,总体支出减少的速度较慢,主要归因于住院护理利用率的逐步下降.
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