Tufts University School of Medicine, Boston, MA, USA.
Acad Pediatr. 2012 Nov-Dec;12(6):489-94. doi: 10.1016/j.acap.2012.07.001. Epub 2012 Sep 16.
To compare the costs of redetermining disability to potential savings in Supplemental Security Income payments associated with different strategies for implementing Continuing Disability Reviews (CDRs) among children potentially enrolled in SSI from 2012 to 2021.
We reviewed publicly available reports from the Social Security Administration and Government Accountability Office to estimate costs and savings. We considered CDRs for children ages 1-17 years, excluding mandated low-birth weight and age 18 redeterminations that SSA routinely has performed.
If in 2012 the Social Security Administration performs the same number of CDRs for children as in 2010 (16,677, 1% of eligibles) at a cessation rate of 15%, the agency would experience net savings of approximately $145 million in benefit payments. If CDR numbers increased to the greatest level ever (183,211, 22% of eligibles, in 1999) at the same cessation rate, the agency would save approximately $1.6 billion in benefit payments.
Increasing the numbers of CDRs for children represents a considerable opportunity for savings. Recognizing the dynamic nature of disability, the agency could reassess the persistence of disability systematically; doing so could free up resources from children who are no longer eligible and help the agency better direct its benefits to recipients with ongoing disability and whose families need support to meet the extra costs associated with raising a child with a major disability.
比较重新确定残疾状况的成本与潜在储蓄，以评估在 2012 年至 2021 年期间，实施持续性残障审查（CDR）的不同策略对潜在参加补充保障收入（SSI）的儿童的相关储蓄效益。
我们审查了来自社会保障管理局和政府问责局的公开报告，以估算成本和储蓄。我们考虑了 1 至 17 岁儿童的 CDR，排除了社会保障局例行开展的强制性低出生体重和 18 岁重新确定。
如果在 2012 年，社会保障管理局执行与 2010 年相同数量的儿童 CDR（16677 名，占合格人数的 1%），停止率为 15%，则该机构在福利支付方面将节省约 1.45 亿美元。如果 CDR 数量增加到历史最高水平（183211 名，占合格人数的 22%，在 1999 年），且停止率相同，则该机构将节省约 16 亿美元的福利支付。
增加儿童 CDR 的数量代表了相当大的储蓄机会。认识到残疾状况的动态性质，该机构可以有系统地重新评估残疾的持续性；这样做可以使不再符合条件的儿童释放资源，并帮助该机构更好地将福利发放给持续残疾且其家庭需要额外支持以应对抚养残疾儿童的额外费用的受益人。
