市政卫生服务医疗保险豁免计划的影响。
Impact of municipal health services Medicare waiver program.
作者信息
Fleming G V, Lyttle C S, Andersen R M, Champney T F, Hausner T
出版信息
Health Care Financ Rev. 1987 Spring;8(3):13-25.
A major goal of the municipal health services program (MHSP) was improvement of health services for the elderly while containing Medicare reimbursement. A Health Care Financing Administration financed Medicare waiver program provided some additional benefits to Medicare Part B enrollees who used the MHSP clinics. Disadvantaged and sicker elderly groups were underrepresented in MHSP facilities. However, even after taking these differences between MHSP and other patients into account, analyses of Medicare records showed that participants in this program had lower reimbursement for hospital inpatient, outpatient, and emergency room services. Also, participants had higher reimbursements for physicians' ambulatory and ancillary care. The net result was total Medicare reimbursements were decreased for program participants.
市政卫生服务项目（MHSP）的一个主要目标是在控制医疗保险报销费用的同时，改善老年人的医疗服务。医疗保健财务管理局资助的医疗保险豁免项目为使用MHSP诊所的医疗保险B部分参保人提供了一些额外福利。弱势群体和病情较重的老年人群体在MHSP设施中的占比不足。然而，即使考虑到MHSP与其他患者之间的这些差异，对医疗保险记录的分析表明，该项目的参与者在医院住院、门诊和急诊室服务方面的报销费用较低。此外，参与者在医生门诊和辅助护理方面的报销费用较高。最终结果是该项目参与者的医疗保险报销总额减少了。
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