医疗保险D部分偏好的药房网络和药房关闭的风险, 2014-23
Jenny S Guadamuz1, G Caleb Alexander2, Genevieve P Kanter3
1Jenny S. Guadamuz (jennyguadamuz@berkeley.edu), University of California Berkeley, Berkeley, California.
Health affairs (Project Hope)
|May 5, 2025
概括
医疗保险D部分计划创建首选的药房网络,经常排除独立和少数社区药房. 这些非首选药房面临着更高的关闭风险.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 药房管理 药房管理
- 健康 公平 卫生 公平
背景情况:
- 医疗保险D部分处方药计划利用首选的药房网络来控制成本并指导受益人.
- 这些网络可以影响患者的选择和药房的可行性.
研究的目的:
- 调查医疗保险D部分计划中首选药房网络纳入的差异.
- 检查优先网络地位与药房关闭风险之间的关联.
主要方法:
- 对医疗保险D部分计划网络数据的分析.
- 优选与非优选药房特征的比较,包括位置和所有权.
- 基于网络状态的药房关闭率的统计分析.
主要成果:
- 独立药房和低收入,黑人和拉丁裔社区的药房不太可能被纳入首选的D部分网络.
- 与优先药房相比,被排除在优先网络之外的药房的关闭可能性增加了70-350%.
结论:
- 医疗保险 (Medicare) D部分优选网络可能会加剧医疗不平等现象,因为它会使服务于弱势群体的药房处于不成比例的劣势.
- 需要针对网络设计的政策,以确保所有医疗保险受益人平等地获得社区药房.
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