在私人医疗保险计划的双重登记受益人中进行有利的选择
Daria Pelech1, Ru Ding2, Jing Guo3
1Daria Pelech (daria.pelech@cbo.gov), Congressional Budget Office, Washington, D.C.
Health affairs (Project Hope)
|October 6, 2025
概括
健康的个人更有可能注册私人医疗保险计划,这使得医疗保险和医疗补助双重注册者的支出评估变得复杂. 更高的医疗保健费用减少了私人计划的入学率.
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
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗保险和医疗补助双重入学者占计划支出的很大一部分,但在入学人数中占比较小.
- 政策制定者鼓励双重入学者注册私人医疗保险计划,以管理高昂的医疗保健支出.
- 有利选择,即更健康的人选择私人计划,使计划对支出影响的评估变得复杂.
研究的目的:
- 为了调查医疗保险和医疗补助双重入学者之间的选择进入医疗保险计划.
- 在这个人群中分析医疗保健支出和医疗保险计划选择之间的关系.
主要方法:
- 利用了连接的医疗补助和医疗保险索赔数据,从2017-2022年.
- 追踪过渡到双重入学的个人,并比较医疗保险计划选择中的双重入学前支出.
- 利用受益人特征的统计调整来隔离选择效应.
主要成果:
- 发现了有利选择进入私人医疗保险计划的证据.
- 医疗支出增加1%使私人计划入学概率降低1个百分点 (2.3%).
- 这种影响在高支出受益者中最为明显,他们注册私人计划的可能性降低了11个百分点 (25%). 对长期服务的支出增加,并支持所有计划类型的注册人数减少.
结论:
- 在评估私人医疗保险计划中的健康或支出结果时,对潜在的健康状况进行控制至关重要.
- 有利的选择影响了入学模式,特别是在高成本受益者中.
- 这些发现强调了由于选择偏见而评估私人计划影响的复杂性.
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