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从医疗保险管理式医疗中自愿退出:市场因素与残疾受益人

Voluntary disenrollment from Medicare managed care: market factors and disabled beneficiaries.

作者信息

Mobley Lee, McCormack Lauren, Booske Bridget, Wang Jiantong, Brown G Gordon, West Nathan, Lynch Judith, Squire Claudia, Heller Amy

机构信息

RTI International, Research Triangle Park, NC 27709-2194, USA.

出版信息

Health Care Financ Rev. 2005 Spring;26(3):45-62.

Abstract

Disenrollment rates from Medicare managed care plans have been reported to the public as an indicator of health plan quality. Previous studies have shown that voluntary disenrollment rates differ among vulnerable subgroups, and that these rates can reflect patient care experiences. We hypothesized that disabled beneficiaries may be affected differently than other beneficiaries by competitive market factors, due to higher expected expenditures and impaired mobility. Findings suggest that disabled beneficiaries are more likely to experience multiple problems with managed care.

摘要

医疗保险管理式医疗计划的退保率已作为健康计划质量的一项指标向公众公布。此前的研究表明,自愿退保率在弱势群体亚组中存在差异,且这些比率能够反映患者的就医体验。我们推测,由于预期支出较高且行动不便,残疾受益人可能受到竞争市场因素的影响与其他受益人不同。研究结果表明,残疾受益人更有可能在管理式医疗方面遇到多重问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ba6/4194935/cd6104306f31/hcfr-26-3-045-g001.jpg

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