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医疗保险的风险调整后的人头付费法。

Medicare's risk-adjusted capitation method.

作者信息

Grimaldi Paul L

机构信息

State Healthcare Division of Affiliated Computer Services, Inc., Rockville, MD, USA.

出版信息

J Health Care Finance. 2002 Spring;28(3):105-19.

Abstract

Since 1997, the method to establish capitation rates for Medicare beneficiaries who are members of risk-bearing managed care plans has undergone several important developments. This includes the factoring of beneficiary health status into the rate-setting calculations. These changes were expected to increase the number of participating health plans, accelerate Medicare enrollment growth, and slice Medicare spending.

摘要

自1997年以来,为作为承担风险的管理式医疗计划成员的医疗保险受益人确定人均费用率的方法经历了几项重要发展。这包括将受益人健康状况纳入费率设定计算中。这些变化预计会增加参与的健康计划数量,加快医疗保险参保人数增长,并削减医疗保险支出。

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