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患者费用分担创新:前景与陷阱

Patient cost-sharing innovations: promises and pitfalls.

作者信息

Trude Sally, Grossman Joy M

出版信息

Issue Brief Cent Stud Health Syst Change. 2004 Jan(75):1-4.

Abstract

Over the next decade, health plans and employers will refine patient cost sharing to encourage workers to seek more cost-effective care, according to a panel of market and health policy experts at a Center for Studying Health System Change (HSC) conference. Instead of using a single, large deductible, employers and health plans will likely vary patient cost sharing by choice of provider, site and type of service, so patients choosing less effective care options pay more. Employers also will try to limit financial hardships for low-income workers by, for example, varying cost sharing based on workers' income. However, significant obstacles could hinder the effectiveness of emerging cost-sharing strategies, including inadequate information on quality of care and provider resistance.

摘要

在卫生保健系统变革研究中心(HSC)召开的一次会议上,市场与卫生政策专家小组表示,在未来十年里,医疗保健计划和雇主将优化患者成本分担机制,以鼓励员工寻求更具成本效益的医疗服务。雇主和医疗保健计划不会再采用单一的高额免赔额,而是可能根据提供者的选择、服务地点和类型来调整患者的成本分担,这样一来,选择疗效较差的医疗服务的患者将支付更多费用。雇主还会尝试通过例如根据员工收入调整成本分担等方式,来减轻低收入员工的经济负担。然而,一些重大障碍可能会阻碍新出现的成本分担策略的有效性,包括医疗质量信息不足以及提供者的抵触情绪。

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