Birnbaum H, Holland S K, Lenhart G, Reilly H L, Hoffman K, Pardo D P
Health Care Financ Rev. 1991 Summer;12(4):39-48.
Estimates of the savings potential of a managed-care program for a Medicare retiree population in Michigan under a hypothetical Medicare insured group (MIG) are presented in this article. In return for receiving an experience-rated capitation payment, a MIG would administer all Medicare and employer complementary benefits for its enrollees. A study of the financial and operational feasibility of implementing a MIG for retirees of a national corporation involving an analysis of 1986 claims data finds that selected managed-care initiatives implemented by a MIG would generate an annual savings of 3.8 percent of total (Medicare plus complementary) expenditures. Although savings are less than the 5 percent to be retained by Medicare, this finding illustrates the potential for savings from managed-care initiatives to Medicare generally and to MIGs elsewhere, where savings may be greater if constraints are less restrictive.
本文给出了密歇根州医疗保险退休人员群体在假设的医疗保险参保群体（MIG）下管理式医疗计划的潜在节省估算。作为获得经验费率定额支付的回报，MIG将为其参保人管理所有医疗保险和雇主补充福利。一项针对一家全国性公司退休人员实施MIG的财务和运营可行性研究，涉及对1986年索赔数据的分析，结果发现MIG实施的选定管理式医疗举措将使年度节省达到总（医疗保险加补充）支出的3.8%。尽管节省幅度低于医疗保险将留存的5%，但这一发现表明，管理式医疗举措总体上对医疗保险以及其他地方的MIG都有节省潜力，如果限制不那么严格，节省幅度可能会更大。
