Anderson Wayne L, Norton Edward C, Kenney Genevieve S
Research Triangle Institute, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA.
Home Health Care Serv Q. 2003;22(3):19-40. doi: 10.1300/J027v22n03_02.
Some state Medicaid programs have attempted to shift home health care costs to Medicare by using retrospective Medicare maximization billing practices. We used a two-part model with random effects to analyze whether retrospective billing practices increase Medicare expenditures for dual eligibles by analyzing primary data collected from 47 state Medicaid offices supplemented with Medicare Current Beneficiary Survey (MCBS) data from 1992-1997. Retrospective billing practices were projected to increase Medicare home health care expenditures by 73.8 million dollars over six years, although this was not statistically significant. We also found significantly higher Medicare spending in states with lower Medicaid spending levels, suggesting that states with high Medicaid utilization have potential to shift some of these expenditures to Medicare.
一些州医疗补助计划试图通过采用追溯性医疗保险最大化计费做法，将家庭医疗保健成本转嫁给医疗保险。我们使用了一个具有随机效应的两部分模型，通过分析从47个州4个州医疗补助办公室收集的主要数据，并辅以1992 - 1997年医疗保险当前受益人调查（MCBS）数据，来分析追溯性计费做法是否会增加双重资格者的医疗保险支出。预计追溯性计费做法将在六年内使医疗保险家庭医疗保健支出增加7380万美元，尽管这在统计上并不显著。我们还发现，医疗补助支出水平较低的州，医疗保险支出显著更高，这表明医疗补助利用率高的州有可能将其中一些支出转嫁给医疗保险。
