医疗保险风险合同：分析美国老年人口的管理式医疗
Medicare risk contracting: analyzing managed care for the aging population in the USA.
作者信息
Rivers P A, Asubonteng C A, Bumpus M, Munchus G
机构信息
Graduate School of Management & Department of Health Services Administration, University of Alabama at Birmingham, USA.
出版信息
Int J Health Care Qual Assur Inc Leadersh Health Serv. 1999;12(1):25-8. doi: 10.1108/09526869910249659.
This paper focuses on Medicare risk contracting in the USA. The issue of the current method of reimbursement versus Medicare risk contracting is explored. Risk sharing and payment mechanisms are described and analyzed. The strengths and weaknesses (score-card) of Medicare beneficiaries entering HMOs are reviewed. Finally, the issue of selection bias in Medicare HMOs is discussed regarding future implementation strategy.
本文聚焦于美国医疗保险风险合同。探讨了当前报销方式与医疗保险风险合同的问题。描述并分析了风险分担和支付机制。回顾了医疗保险受益人加入健康维护组织（HMO）的优缺点（计分卡）。最后，就未来实施策略讨论了医疗保险健康维护组织中的选择偏差问题。
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