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医疗保险优势牙科福利:在不到一半的美国县提供全面的覆盖
Lisa Simon1, Marko Vujicic2, Kamyar Nasseh3
1Lisa Simon (lsimon@bwh.harvard.edu), Harvard University and Brigham and Women's Hospital, Boston, Massachusetts.
Health affairs (Project Hope)
|June 2, 2025
概括
医疗保险优势计划提供牙科保险,但全面的选择很少. 在2023年,不到一半的县有机会获得全面的牙科计划,突出口腔健康福利的差距.
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
- 牙医保险 获得牙医保险 获得牙医保险
背景情况:
- 传统医疗保险不包括牙科保险,尽管口腔健康与整体健康的联系.
- 医疗保险优势 (MA) 计划可以提供牙科作为补充福利.
- 有限的数据存在于MA牙科覆盖的地理可用性.
研究的目的:
- 检查2023年各县的Medicare Advantage计划中牙科保险的可用性.
- 确定与MA牙科福利可用性相关的特征.
- 在医疗保险优势中为有关牙科保险的政策提供信息.
主要方法:
- 来自医疗保险和医疗补助服务中心关于MA补充福利的公共数据的分析.
- 检查了2023年在县级获得牙科福利的情况.
- 利用波桑回归来评估县特征与牙科福利的可用性之间的关联.
主要成果:
- 受益人平均可以获得34.9个有牙科福利的MA计划,但只有1.7个具有全面的牙科保险.
- 在全国范围内,39.9%的县提供至少一个全面的牙科计划.
- 较大的人口,更高的MA市场透率和较低的保险商度与更大的牙科福利可用性有关.
结论:
- 在医疗保险优势计划中,全面的牙科保险是有限的,具有显著的地理差异.
- 人口规模和市场竞争等因素影响牙科福利的可用性.
- 政策考虑应包括MA牙科计划的质量基准及其在招生激励方面的作用.
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