Kreig J, Hergenrader R
Keenan and Associates, Torrance, CA, USA.
Health Care Strateg Manage. 1997 Oct;15(10):1, 21-3.
Hospital employers need to evaluate the true cost of their medical benefits program by comparing HMO benefits and premiums versus a self-funded plan's benefits and costs. Hospitals need to evaluate the cost of providing services at their own facility, then compare the capitation income derived from the HMO for providing these same services at their own facilities against the paid claims dollars that are returned to them when plan participants receive services at their own facilities.
医院雇主需要通过比较健康维护组织(HMO)的福利和保费与自筹资金计划的福利和成本,来评估其医疗福利计划的真实成本。医院需要评估在其自身设施提供服务的成本,然后将在其自身设施为健康维护组织提供这些相同服务所获得的人头费收入,与当计划参与者在其自身设施接受服务时返还给他们的已支付理赔金额进行比较。