评估"负担得起的医疗保健法"的长期服务和支持再平衡计划
1Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Health services research
|August 22, 2025
概括
均衡激励计划 (BIP) 增加了家庭和社区服务 (HCBS) 的员工人数13.24%,特别是与绩效目标相关联时. 社区首选 (CFC) 没有对HCBS员工规模产生重大影响.
科学领域:
- 医疗服务研究
- 卫生政策
- 公共卫生
背景情况:
- 长期支持和服务 (LTSS) 正日益转向以社区为基础的环境.
- 均衡激励计划 (BIP) 和社区首选 (CFC) 是旨在支持这种再平衡的联邦倡议.
- 了解这些计划对劳动力的影响对于有效实施政策至关重要.
研究的目的:
- 评估BIP和CFC对LTSS工作人员规模和组成的影响.
- 确定BIP的绩效目标是否影响了其扩大社区LTSS工作人员的有效性.
主要方法:
- 为了分析BIP和CFC的影响,采用了叠加差异设计.
- 利用美国社区调查 (2005-2021) 的劳动力和人口统计数据.
- 这项研究考察了每1000名65岁以上的LTSS劳动力总数,社区和机构的变化.
主要成果:
- 在参与国家, BIP 显著增加了家庭和社区服务 (HCBS) 劳动力13.24%.
- 在有业绩目标的州, BIP 对医疗保健部门员工的积极影响更为明显.
- 无论是BIP还是CFC都没有显示出对机构LTSS员工规模的显著影响.
结论:
- 联邦政府为HCBS提供资金以达到可衡量的绩效目标,鼓励各州扩大社区服务.
- 政策制定者应该考虑基于绩效的激励措施,以推动高碳碳水化合物行业的进一步增长.
- 这些发现表明,战略政策设计可以提高旨在重新平衡LTSS的联邦计划的有效性.
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