Zuckerman S, Holahan J
Health Policy Center, Urban Institute, Washington, DC 20037.
Inquiry. 1992 Winter;29(4):391-402.
Congress adopted a policy of Volume Performance Standards that will adjust Medicare fees downward (or upward) in direct relation to the amount that spending exceeds (or falls below) a preset target. Using data from the 1985 through 1989 Medicare Part B Annual Data (BMAD), we show there are wide differences in the rate of growth in volume and intensity across types of services, specialties, and geographic areas. This suggests the current policy that bases adjustments on two national standards for surgical and nonsurgical services could lead to inequitable fee rewards and penalties. A greater number of targets based on more homogeneous service categories could reduce these inequities.
国会通过了一项“量效标准”政策，该政策将根据支出超过（或低于）预设目标的金额直接下调（或上调）医疗保险费用。利用1985年至1989年医疗保险B部分年度数据（BMAD），我们发现不同类型服务、专科和地理区域的量和强度增长率存在很大差异。这表明当前基于手术和非手术服务两项国家标准进行调整的政策可能会导致不公平的费用奖惩。基于更同质服务类别的更多目标可以减少这些不公平现象。
