为按人头付费系统设定支付费率：各种方案的比较。
Setting payment rates for capitated systems: a comparison of various alternatives.
作者信息
Anderson G F, Steinberg E P, Powe N R, Antebi S, Whittle J, Horn S, Herbert R
机构信息
Center for Hospital Finance and Management, Johns Hopkins Medical Institutions, Baltimore, MD.
出版信息
Inquiry. 1990 Fall;27(3):225-33.
Numerous proposals have been suggested to revise the current adjusted annual per capita cost (AAPCC) method for paying HMOs in the Medicare program. Several evaluations of the various alternatives conclude that including a prior utilization variable is the most promising alternative. In this paper, using statistical and other criteria, we compare the current AAPCC method with three different prior utilization models. The results suggest that all three prior utilization models can predict expenditures for either individuals or a group--drawn from a cross section and a risk selected sample of aged Medicare beneficiaries--more accurately than the AAPCC method. Of the three prior utilization measures, Payment Amount for Capitated Systems (PACS) predicts actual expenditures most accurately.
人们提出了许多建议，以修订医疗保险计划中用于支付健康维护组织（HMO）费用的现行调整后人均年度成本（AAPCC）方法。对各种替代方案的多项评估得出结论，纳入先前的使用变量是最有前景的替代方案。在本文中，我们使用统计和其他标准，将现行的AAPCC方法与三种不同的先前使用模型进行比较。结果表明，对于从老年医疗保险受益人的横截面和风险选择样本中抽取的个人或群体，所有三种先前使用模型都比AAPCC方法更能准确预测支出。在这三种先前使用度量中，按人头付费系统支付金额（PACS）最能准确预测实际支出。
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