Hurley Robert E, Retchin Sheldon M
Department of Health Administration (REH), Virginia Commonwealth University, Richmond, USA.
Am J Manag Care. 2006 Jan;12(1):40-4.
Two decades of efforts to promote managed care models in Medicare and Medicaid have resulted in vastly different experiences as measured by enrollment, plan participation, and ability to achieve the goals of public policy-makers. The Medicare Modernization Act of 2003 introduced a major transformation to engage and retain private health plans. It is useful for plan administrators to consider why the trajectories for the programs have been so divergent and to assess prospects for success in the Medicare Advantage initiative.
二十年来，在医疗保险和医疗补助计划中推广管理式医疗模式的努力，在参保人数、计划参与度以及实现公共政策制定者目标的能力等方面，带来了截然不同的结果。2003年的《医疗保险现代化法案》带来了一项重大变革，以吸引并留住私人健康保险计划。计划管理者思考这些项目的发展轨迹为何如此不同，并评估医疗保险优势计划的成功前景，是很有必要的。
