在医疗保险优势的住院价格在医院之间和医院内略有变化
Grace Mackleby1, Geronimo Bejarano2, David J Meyers3
1Grace Mackleby (gracemcc@usc.edu), University of Southern California, Los Angeles, California.
Health affairs (Project Hope)
|October 6, 2025
概括
医疗保险优势 (MA) 提供者价格与传统医疗保险紧密相匹配,平均为传统费率的97%. 虽然存在医院特定的变化,但MA价格与商业或医疗补助费率相比,波动较小.
科学领域:
- 卫生经济学 卫生经济学
- 医疗保健政策 医疗保健政策
- 医疗服务 研究 研究 研究 医疗服务
背景情况:
- 医疗保险优势 (MA) 是医疗保险的一个不断增长的部分.
- 了解MA和传统医疗保险之间的供应商价格差异对于政策和患者成本至关重要.
- 之前的研究表明,不同类型的保险价格存在差异.
研究的目的:
- 为了比较医疗保险优势和传统医疗保险之间的住院医疗服务提供者的价格.
- 分析跨医院和保险公司的MA服务价格变化的程度.
- 为了将MA价格的变化与商业和医疗补助价格进行比较.
主要方法:
- 利用国家医疗保健索赔数据进行分析.
- 计算了MA和传统医疗保险的住院平均价格.
- 评估了MA价格在传统医疗保险价格5%门内的医院的百分比.
- 对MA,商业和医疗补助的定量价格变化.
主要成果:
- 平均住院医疗保险优势价格为传统医疗保险价格的97%.
- 只有39%的医院的平均住院MA价格在传统医疗保险的5%以内.
- 与商业或医疗补助价格相比,医疗保险优势价格的变化明显较小.
结论:
- 医疗保险优势提供者的价格通常与传统的医疗保险费率保持一致.
- 尽管整体相似,但在MA内存在显著的医院级价格差异.
- 马的价格显示出比商业或医疗补助价格更大的稳定性和可预测性.
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