补充保险对医疗保险参保者服务使用情况的影响。
Effects of supplemental coverage on use of services by Medicare enrollees.
作者信息
Christensen S, Shinogle J
机构信息
US Congressional Budget Office, Washington, DC 20515, USA.
出版信息
Health Care Financ Rev. 1997 Fall;19(1):5-17.
Abstract
This article estimates the extent to which private insurance supplements affect use of services by Medicare enrollees. Three types of supplements to Medicare's coverage are examined--Health Maintenance Organizations (HMOs), medigap (MGP) plans, and employment-based indemnity (EBI) plans. While each kind of supplement reduces cost sharing on Medicare-covered services, only HMOs do so without increasing enrollees' overall use of services. Use of services by HMO enrollees is about 4 percent lower than use by similar Medicare enrollees with no insurance supplement. By contrast, use of services by enrollees with MGP coverage is 28 percent higher, and use of services by enrollees with EBI plans is 17 percent higher.
摘要
本文估计了私人保险补充对医疗保险参保者服务使用情况的影响程度。研究了医疗保险覆盖范围的三种补充类型——健康维护组织（HMO）、补充医疗保险（MGP）计划和基于就业的定额给付（EBI）计划。虽然每种补充都减少了医疗保险覆盖服务的费用分担，但只有健康维护组织在不增加参保者总体服务使用量的情况下做到了这一点。健康维护组织参保者的服务使用量比没有保险补充的类似医疗保险参保者低约4%。相比之下，有补充医疗保险覆盖的参保者服务使用量高28%，有基于就业的定额给付计划的参保者服务使用量高17%。
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本文引用的文献
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