Long Sharon K
The Urban Institute, Washington, DC, 20037, USA.
Med Care Res Rev. 2008 Oct;65(5):638-48. doi: 10.1177/1077558708316930. Epub 2008 Apr 22.
Managed care is now the norm for many on Medicaid, with approximately 19 million people on Medicaid enrolled in health maintenance organizations. In 2005, nearly 300 plans nationwide participated in state Medicaid managed care programs, with many of those plans operating under for-profit ownership. Concerns about the impact of plan ownership on access to care arise because of differences in the incentives in place in for-profit and nonprofit organizations that may lead for-profit plans to restrict access to care. Using data from the 2002 National Survey of America's Families on plan enrollment for a national sample of Medicaid enrollees, this study examines the link between for-profit plan ownership and enrollees' access to health care. The results suggest that access to care for Medicaid enrollees may be better under nonprofit plans than for-profit plans.
管理式医疗如今已成为许多医疗补助计划受益人的常态,约有1900万医疗补助计划受益人加入了健康维护组织。2005年,全国近300个计划参与了州医疗补助管理式医疗项目,其中许多计划由营利性机构运营。由于营利性组织和非营利性组织的激励机制存在差异,可能导致营利性计划限制医疗服务的获取,因此人们对计划所有权对医疗服务获取的影响感到担忧。本研究利用2002年全美国庭调查中关于全国医疗补助计划受益人的计划登记数据,考察了营利性计划所有权与受益人获得医疗保健之间的联系。结果表明,与营利性计划相比,非营利性计划下医疗补助受益人的医疗服务获取情况可能更好。