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妇女健康服务:医疗补助管理式医疗的结构调整

Women's health services: restructuring for Medicaid managed care.

作者信息

Loughlin J, Bronner E F, Mascari J S

机构信息

Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, USA.

出版信息

J Ambul Care Manage. 1997 Apr;20(2):70-7. doi: 10.1097/00004479-199704000-00011.

DOI:10.1097/00004479-199704000-00011
PMID:10181608
Abstract

New Jersey health care providers face the need to change dramatically the way health care is delivered as it enters a new era of managed care. This year, more than 24% of New Jersey's total population is enrolled in commercial managed care plans (New Jersey Department of Insurance, 1996). In addition, the state's Medicaid agency took steps to improve the delivery of health services to recipients by initiating implementation activities to transition from the traditional Medicaid program to a managed care model. Eighty-two percent of New Jersey's Aid to Families with Dependent Children (AFDC) and related populations have already been enrolled in managed care. The state plans to expand enrollment in managed care to the remaining 400,000 Medicaid beneficiaries. Communities with high Medicaid populations are challenged with the need to move through the managed care evolution at an accelerated rate.

摘要

随着医疗保健进入管理式医疗的新时代,新泽西州的医疗保健提供者面临着大幅改变医疗服务提供方式的需求。今年,新泽西州总人口中有超过24%参加了商业管理式医疗计划(新泽西州保险部,1996年)。此外,该州的医疗补助机构采取措施,通过启动从传统医疗补助计划向管理式医疗模式过渡的实施活动,来改善向受助者提供的医疗服务。新泽西州82%的抚养子女家庭援助(AFDC)及相关人群已经参加了管理式医疗。该州计划将管理式医疗的参保范围扩大到其余40万医疗补助受益人。医疗补助人口众多的社区面临着以更快速度推进管理式医疗发展的挑战。

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