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确定合理价格:医疗保险心血管服务支付费率

Getting the price right: Medicare payment rates for cardiovascular services.

作者信息

Hayes Kevin J, Pettengill Julian, Stensland Jeffrey

机构信息

Medicare Payment Advisory Commission, Washington, DC, USA.

出版信息

Health Aff (Millwood). 2007 Jan-Feb;26(1):124-36. doi: 10.1377/hlthaff.26.1.124.

Abstract

Specialized, physician-owned cardiac hospitals have grown rapidly. Physicians have also expanded their capability to provide cardiovascular diagnostic services in their offices. In this paper we consider evidence of errors in Medicare's prices for hospital care and physician services and discuss ways to improve the accuracy of those prices. We find that recent proposals to change the inpatient prospective payment system would help dampen hospitals' financial incentives to favor some kinds of patients and related investments. For the physician fee schedule, we suggest that the Centers for Medicare and Medicaid Services (CMS) review the accuracy of prices for high-growth diagnostic services.

摘要

专业化的、由医生所有的心脏病医院发展迅速。医生们在其诊所提供心血管诊断服务的能力也有所增强。在本文中,我们考察了医疗保险中住院医疗和医生服务价格存在错误的证据,并讨论提高这些价格准确性的方法。我们发现,近期改变住院病人前瞻性支付系统的提议将有助于抑制医院在经济利益上对某些类型患者的偏袒及相关投资行为。对于医生收费表,我们建议医疗保险和医疗补助服务中心(CMS)审查高增长诊断服务价格的准确性。

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