Laschober Mary
Mathematica Policy Research, Inc., Washington, DC 20024, USA.
Health Care Financ Rev. 2005 Spring;26(3):63-79.
Beginning January 2006, Medicare beneficiaries will have limited ability to change health plans. We examine the Medicare managed care enrollment and disenrollment behavior of traditionally vulnerable beneficiaries from 1999-2001 to estimate the potential impact of the new enrollment restrictions. Findings that several such groups were more likely to make multiple health plan elections, leave their managed care plan midyear, and/or have higher voluntary disenrollment rates and transfers to original fee-for-service (FFS) Medicare suggest that the lock-in provisions may have greater negative impacts on vulnerable beneficiaries. This article identifies several recommendations that CMS might consider to lessen the detrimental effects on at-risk groups.
从2006年1月起，医疗保险受益人更换健康计划的能力将受到限制。我们研究了1999年至2001年传统弱势受益人的医疗保险管理式医疗参保和退保行为，以估计新参保限制的潜在影响。有研究发现，几个这样的群体更有可能多次选择健康计划、年中离开他们的管理式医疗计划，和/或有更高的自愿退保率以及向原始的按服务付费（FFS）医疗保险转移，这表明锁定条款可能对弱势受益人产生更大的负面影响。本文提出了一些建议，医疗保险和医疗补助服务中心（CMS）可以考虑这些建议来减轻对高危群体的不利影响。
