Kautter John, Pope Gregory C
RTI International, 1440 Main Street, Waltham, MA , 02451, USA,
Int J Health Care Finance Econ. 2014 Jun;14(2):95-108. doi: 10.1007/s10754-013-9139-0. Epub 2013 Dec 24.
The traditional Medicare fee-for-service program may be able to purchase clinical laboratory test services at a lower cost through competitive bidding. Demonstrations of competitive bidding for clinical laboratory tests have been twice mandated or authorized by Congress but never implemented. This article provides a summary and review of the final design of the laboratory competitive bidding demonstration mandated by the Medicare Modernization Act of 2003. The design was analogous to a sealed bid (first price), clearing price auction. Design elements presented include covered laboratory tests and beneficiaries, laboratory bidding and payment status under the demonstration, composite bids, determining bidding winners and the demonstration fee schedule, and quality under the demonstration. Expanded use of competitive bidding in Medicare, including specifically for clinical laboratory tests, has been recommended in some proposals for Medicare reform. The presented design may be a useful point of departure if Medicare clinical laboratory competitive bidding is revived in the future.
传统的医疗保险按服务收费计划或许能够通过竞争性投标以更低的成本购买临床检验服务。国会已两次授权进行临床检验竞争性投标示范，但均未实施。本文对2003年《医疗保险现代化法案》授权的实验室竞争性投标示范的最终设计进行了总结和回顾。该设计类似于密封投标（首价）、清算价格拍卖。介绍的设计要素包括涵盖的实验室检验和受益人、示范下的实验室投标和支付状况、综合投标、确定中标者和示范费用表以及示范下的质量。在一些医疗保险改革提案中，建议在医疗保险中扩大使用竞争性投标，特别是针对临床检验。如果未来恢复医疗保险临床检验竞争性投标，所提出的设计可能是一个有用的出发点。
