Foote Susan Bartlett, Halaas Gwen Wagstrom
Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis, USA.
Health Aff (Millwood). 2006 May-Jun;25(3):864-8. doi: 10.1377/hlthaff.25.3.864.
The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) provides economic incentives that favor health plans over traditional fee-for-service (FFS) Medicare. This reflects an ideological preference for private plans rather than government-administered pricing and recognition that private plans can use tools effectively to improve quality. However, enrollment projections indicate that FFS will continue to attract the majority of beneficiaries for years to come. We argue that MMA's contractor reform provisions create the opportunity to build critical FFS infrastructure, and contractors have the potential to encourage quality and manage utilization to compete with private plans in a modernized Medicare.
《医疗保险处方药、改进与现代化法案》（MMA）提供了经济激励措施，使健康计划比传统的按服务收费（FFS）医疗保险更具优势。这反映了对私人计划而非政府定价的意识形态偏好，以及认识到私人计划可以有效地利用工具来提高质量。然而，参保人数预测表明，在未来几年，按服务收费仍将吸引大多数受益人。我们认为，MMA的承包商改革条款创造了建立关键的按服务收费基础设施的机会，并且承包商有潜力鼓励提高质量和管理利用率，以便在现代化的医疗保险中与私人计划竞争。
