亚利桑那州针对长期护理受益人的按人头付费医疗补助计划中的服务利用情况。
Utilization of services in Arizona's capitated Medicaid program for long-term care beneficiaries.
作者信息
McCall N, Korb J
机构信息
Laguna Research Associates, USA.
出版信息
Health Care Financ Rev. 1997 Winter;19(2):119-34.
The Arizona Long-Term Care System (ALTCS), Arizona's Medicaid program for long-term care (LTC) beneficiaries, capitates contractors to provide a full range of acute and LTC services to financially-eligible beneficiaries determined to be at risk of institutionalization. This article compares the acute care utilization experience of LTC beneficiaries in ALTCS with those in a fee-for-service (FFS) Medicaid program, linking data from both the Medicare and the Medicaid program files. Patterns of use observed in Arizona seem more consistent with a managed care environment than those observed in the FFS comparison. Rates of acute care utilization observed for both the capitated and the FFS program should be of interest to States considering incorporating LTC beneficiaries into their Medicaid managed care program.
亚利桑那长期护理系统（ALTCS）是亚利桑那州为长期护理（LTC）受益人设立的医疗补助计划，它向承包商提供按人头付费的方式，以便为经判定有入住机构护理风险且符合财务资格的受益人提供全方位的急症和长期护理服务。本文将ALTCS中LTC受益人的急症护理使用情况与按服务收费（FFS）医疗补助计划中的受益人进行比较，将医疗保险和医疗补助计划档案中的数据相联系。在亚利桑那观察到的使用模式似乎比在FFS比较中观察到的模式更符合管理式医疗环境。对于考虑将LTC受益人纳入其医疗补助管理式医疗计划的各州而言，按人头付费计划和FFS计划中观察到的急症护理使用率都应受到关注。
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