选择进入医疗保险优势的趋势
Anuj Gangopadhyaya1, Bowen Garrett2
1Department of Economics, Quinlan School of Business, Loyola University Chicago, Chicago, Illinois, USA.
Health economics
|March 10, 2026
概括
医疗保险优势 (MA) 招生增长引发了一些担忧. 自2017年以来,MA注册者显示预测成本更高,主要是由于双重资格,而传统的医疗保险 (TM) 注册者则显示更高的预测成本.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 老年学是一门学科.
背景情况:
- 医疗保险优势 (MA) 注册人数急剧增加,从2013年到2023年翻了一番多.
- 这种增长引发了对风险选择,医疗保健支出以及传统医疗保险 (TM) 支付MA支付的基准准确性的担忧.
研究的目的:
- 分析从2009年到2020年的医疗保险优势 (MA) 选择趋势.
- 为了评估MA入学者是否与TM入学者相比,随着时间的推移,呈现出不同的风险概况.
- 评估对医疗保险的风险调整系统的影响.
主要方法:
- 使用的行政和医疗保险当前受益者调查数据 (2009-2020年).
- 基于受访者特征的TM部分A和B支出估计回归模型.
- 应用TM支出模型来预测MA入学者的成本,以评估风险选择.
主要成果:
- 自2017年以来,MA入学者与TM入学者相比,预计的TM支出高出5-6%.
- 在MA中,双重资格受益人的比例越来越高,这显著地推动了这些更高的预测成本.
- 虽然MA选择显示小组内的差异性风险很小,但TM入学者的特征随着时间的推移转向预测支出较低.
结论:
- 医疗保险优势 (MA) 选择的性质在最近几年有了质的转变.
- 在MA和TM之间分歧的入学特征引发了对当前风险调整系统准确性的质疑.
- 需要进行进一步的研究,以确保随着入学人群的发展,确保公平而准确的风险调整.
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