州医疗补助健康维护组织政策与特殊需求儿童

State Medicaid health maintenance organization policies and special-needs children.

作者信息

Fox H B, Wicks L B, Newacheck P W

机构信息

Fox Health Policy Consultants, Washington, DC 20006.

出版信息

Health Care Financ Rev. 1993 Fall;15(1):25-37.

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4193416/

Abstract

Little research has been done to ascertain what enrollment in a health maintenance organization (HMO) may mean for the care of Medicaid recipients who regularly require specialty health services. This article presents the results of a survey of all State Medicaid agencies regarding their policies for enrolling and serving special-needs children in HMOs. The survey revealed that many States have implemented one or more strategies to protect special-needs Medicaid recipients enrolled in HMOs. The survey results suggest, however, that such strategies are too limited in scope to ensure appropriate access to specialty services for all children with special health needs.

摘要

关于参加健康维护组织（HMO）对于那些经常需要专科医疗服务的医疗补助受助者的护理意味着什么，目前几乎没有进行过相关研究。本文呈现了一项针对所有州医疗补助机构关于其在HMO中招收和服务有特殊需求儿童的政策的调查结果。该调查显示，许多州已经实施了一种或多种策略来保护参加HMO的有特殊需求的医疗补助受助者。然而，调查结果表明，这些策略的范围过于有限，无法确保所有有特殊健康需求的儿童都能获得适当的专科服务。

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