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Health Serv Res. 1990 Oct;25(4):593-613.
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Health Care Financ Rev. 1988 Fall;10(1):37-49.
2
Medicare capitation and quality of care for the frail elderly.医疗保险按人头付费与体弱老年人的医疗质量。
Health Care Financ Rev. 1986;1986(Spec No):57-63.
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National health expenditures, 1984.1984年国家卫生支出
Health Care Financ Rev. 1985 Fall;7(1):1-35.
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The use and costs of Medicare services in the last 2 years of life.临终前两年医疗保险服务的使用情况及费用。
Health Care Financ Rev. 1984 Spring;5(3):117-31.
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Pre-enrollment reimbursement patterns of Medicare beneficiaries enrolled in "at-risk" HMOs.参加“风险”健康维护组织（HMO）的医疗保险受益人的预注册报销模式。
Health Care Financ Rev. 1982 Sep;4(1):55-73.
6
Risk differential between Medicare beneficiaries enrolled and not enrolled in an HMO.参加和未参加健康维护组织（HMO）的医疗保险受益人的风险差异。
Health Care Financ Rev. 1980 Winter;1(3):91-9.
7
Membership duration and utilization rates in a prepaid group practice.
Med Care. 1981 Dec;19(12):1194-210. doi: 10.1097/00005650-198112000-00003.
8
Health maintenance organizations and the rationing of medical care.健康维护组织与医疗保健的配给
Milbank Mem Fund Q Health Soc. 1982 Spring;60(2):268-306.
9
A controlled trial of the effect of a prepaid group practice on use of services.一项关于预付费团体医疗模式对服务使用影响的对照试验。
N Engl J Med. 1984 Jun 7;310(23):1505-10. doi: 10.1056/NEJM198406073102305.
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Evidence for self-selection among health maintenance organization enrollees.
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健康维护组织（HMOs）能降低医疗保健成本吗？对两个医疗保险HMO示范项目的多变量分析。

Do HMOs reduce health care costs? A multivariate analysis of two Medicare HMO demonstration projects.

作者信息

McCombs J S, Kasper J D, Riley G F

机构信息

School of Pharmacy, University of Southern California, Los Angeles 90033.

出版信息

Health Serv Res. 1990 Oct;25(4):593-613.

PMID:2211129
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1065647/
Abstract

Charge data from two Medicare HMO demonstration projects were analyzed to determine if prepaid plans achieved cost savings for enrolled beneficiaries. Fallon Community Health Plan of Massachusetts did not reduce total charges significantly for survivors in their first year postenrollment. However, the plan enjoyed reductions in total charges per month after the first year of nearly 38 percent (41 percent for Part A; 31 percent for Part B). Savings for decedents were more modest, reducing total charges per month by around 27 percent (19 percent, Part A; 68 percent, Part B). Greater Marshfield Community Health Plan of Wisconsin was not successful in controlling charges during the demonstration period. Marshfield incurred losses in the first postenrollment year for survivors due to a 38 percent increase in total charges per month (18 percent, Part A; 73 percent, Part B). In the second year postenrollment, the Marshfield plan was able to reduce losses for survivors to roughly 11 percent (-6 percent, Part A; 44 percent, Part B). For decedents, Marshfield experienced an increase in total charges per month of approximately 21 percent relative to fee-for-service comparisons, with Part B charges again much higher than those of the comparison group (47 percent).

摘要

对来自两个医疗保险健康维护组织示范项目的费用数据进行了分析，以确定预付计划是否为参保受益人节省了成本。马萨诸塞州的法伦社区健康计划在参保后第一年并未显著降低幸存者的总费用。然而，该计划在第一年之后每月总费用降低了近38%（A部分降低41%；B部分降低31%）。死者的费用节省较为有限，每月总费用降低了约27%（A部分降低19%；B部分降低68%）。威斯康星州的大沼泽地社区健康计划在示范期间未能成功控制费用。由于每月总费用增加38%（A部分增加18%；B部分增加73%），大沼泽地在参保后的第一年，幸存者出现了亏损。在参保后的第二年，大沼泽地计划能够将幸存者的亏损降至约11%（A部分为-6%；B部分为44%）。对于死者，与按服务收费的比较相比，大沼泽地每月总费用增加了约21%，B部分费用再次远高于比较组（47%）。