长期服务和支持补充福利在医疗保险优势计划中的补充福利
Deepon Bhaumik1, David C Grabowski1
1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
JAMA network open
|August 11, 2025
概括
提供长期服务和支持 (LTSS) 福利的Medicare Advantage计划增加了计划的可用性,但受益者入学率下降. 对于MA计划扩大这些关键的LTSS好处,存在未开发的潜力.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 老年学是一门学科.
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗保险优势 (MA) 计划自2019年以来可以提供长期服务和支持 (LTSS) 补充福利.
- 这些LTSS福利在MA计划中的普及率和入学趋势在很大程度上仍未得到审查.
研究的目的:
- 调查MA计划提供的LTSS补充福利的流行情况.
- 分析提供LTSS福利的MA计划中受益人的入学趋势.
主要方法:
- 一项纵向队列研究分析了医疗保险和医疗补助服务中心从2019年到2025年的数据.
- 该研究重点关注健康维护组织和首选提供者组织的MA计划.
- 关键指标包括提供LTSS的计划数量,受益者入学份额和福利慷慨.
主要成果:
- 提供LTSS福利的MA计划数量从2019年到2025年增加,但提供这些福利的计划的总体份额略有下降.
- 从2019年到2025年,受益人注册的MA计划与LTSS福利的受益人注册率大幅下降.
- 特定的LTSS,如家庭支持服务和非阿片类药物疼痛管理,提供量增加,而照顾者支持服务减少.
结论:
- 自MA计划引入以来,LTSS福利在MA计划中的可用性没有发生重大变化.
- 受益者入学人数下降表明,MA计划扩大LTSS产品的利用不足和错失机会.
- 需要进一步的研究来了解入学障碍,并优化医疗保险优势中的LTSS福利设计.
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