Murtaugh Christopher M, McCall Nelda, Moore Stanley, Meadow Ann
Center for Home Care Policy and Research, Visiting Nurse Service of New York, USA.
Health Aff (Millwood). 2003 Sep-Oct;22(5):146-56. doi: 10.1377/hlthaff.22.5.146.
The Balanced Budget Act of 1997 mandated a major overhaul in Medicare payment for home health care with an interim payment system (IPS) preceding a prospective payment system (PPS). This study extends an earlier analysis of the impact of the IPS to determine whether home health use and spendingtrends changed after the introduction of the PPS. The rapid decline in the incidence of use and visits per user under the IPS slowed in its final year and then picked up again in the first year of the PPS. In addition, average payment per visit increased sharply under the PPS. Little is known about the impact of continued large reductions in home health services since 1999.
1997年的《平衡预算法案》要求对医疗保险中家庭医疗保健支付进行重大改革，在实行前瞻性支付系统（PPS）之前先实行临时支付系统（IPS）。本研究扩展了对IPS影响的早期分析，以确定PPS推出后家庭医疗保健的使用和支出趋势是否发生了变化。在IPS下，使用发生率和每位用户就诊次数的快速下降在其最后一年放缓，然后在PPS的第一年再次回升。此外，PPS下每次就诊的平均支付大幅增加。自1999年以来，家庭医疗保健服务持续大幅削减的影响鲜为人知。
