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医疗保险签约对你的管理式医疗组织合适吗?

Is Medicare contracting right for your managed care organization?

作者信息

Polich C L, Riley P A

机构信息

United HealthCare Corporation, Minneapolis, MN 55440.

出版信息

Med Interface. 1994 May;7(5):78-80, 83-4, 90.

PMID:10134346
Abstract

Americans older than 65 years represent the fastest-growing segment of the population. Today, the elderly comprise 12% of the population but account for one-third of health care spending. By the turn of the century, they will use half of these resources. Ironically, the elderly have been affected little by the managed care revolution; only 2.6 million have enrolled in HMOs that have contracts with the federal Medicare program to provide comprehensive health services to that population. In this article, the author explains the different types of Medicare managed care contracts, the advantages of these contracts, and how to succeed in this growing area of opportunity.

摘要

65岁以上的美国人是人口增长最快的群体。如今,老年人占人口的12%,却占医疗保健支出的三分之一。到本世纪之交,他们将消耗这些资源的一半。具有讽刺意味的是,老年人受管理式医疗革命的影响很小;只有260万人参加了与联邦医疗保险计划签订合同、为该群体提供全面医疗服务的健康维护组织。在本文中,作者解释了医疗保险管理式医疗合同的不同类型、这些合同的优势,以及如何在这个不断增长的机遇领域取得成功。

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