White Chapin
Commonwealth Fund in New York City, USA.
Health Aff (Millwood). 2008 May-Jun;27(3):793-802. doi: 10.1377/hlthaff.27.3.793.
So-called excess growth in Medicare spending per beneficiary has varied widely and has slowed in recent years. The annual rate of excess growth fell from 5.6 percent during 1975-1983, to 2.1 percent during 1983-1997, to only 0.5 percent during 1997-2005. Changes in payment policies and regulations can help explain the observed slowdown. These include new prospective payment systems for hospitals and postacute care providers, and controls on aggregate Medicare physician spending. Competing explanations-increases in managed care enrollment, changes in Medicare cost sharing, and a systemwide spending slowdown-do not account for the slowdown.
所谓的医疗保险每位受益人的支出过度增长情况差异很大，且近年来已有所放缓。过度增长的年增长率从1975 - 1983年期间的5.6%降至1983 - 1997年期间的2.1%，再降至1997 - 2005年期间的仅0.5%。支付政策和法规的变化有助于解释观察到的放缓现象。这些包括针对医院和急性后期护理提供者的新的前瞻性支付系统，以及对医疗保险医生总支出的控制。其他竞争性解释——管理式医疗参保人数的增加、医疗保险费用分担的变化以及全系统支出放缓——并不能解释这种放缓。
