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竞争性市场环境中的按服务收费医疗保险制度

Fee-for-service Medicare in a competitive market environment.

作者信息

Dowd Bryan E, Coulam Robert F, Feldman Roger, Pizer Steven D

机构信息

Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis 55455, USA.

出版信息

Health Care Financ Rev. 2005;27(2):113-26.

Abstract

Since its inception, the Medicare Program has allowed for the participation of private health plans, but the relationship of private plans to the government-sponsored fee-for-service (FFS) plan has been the subject of debate. Increased payments to private plans, the introduction of regional preferred provider organizations (PPOs), and a mandated demonstration of price competition that includes FFS Medicare reflect an ongoing attempt to define the role of private plans. The purpose of this article is to explore the roles of private plans and FFS Medicare and to attempt to identify the advantages and disadvantages of each.

摘要

自医疗保险计划启动以来,它允许私人健康计划参与,但私人计划与政府资助的按服务收费(FFS)计划之间的关系一直是争论的焦点。对私人计划增加支付、引入区域优先提供者组织(PPO)以及包括FFS医疗保险在内的价格竞争强制示范,都反映出人们一直在努力界定私人计划的角色。本文旨在探讨私人计划和FFS医疗保险的角色,并试图找出各自的优缺点。

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