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让参保人参与鼓励促进健康行为的医疗补助计划。

Engaging Beneficiaries In Medicaid Programs That Incentivize Health-Promoting Behaviors.

机构信息

Madhulika Vulimiri is a senior Medicaid strategist at the North Carolina Department of Health and Human Services, in Raleigh, North Carolina. She was a master of public policy student in the Sanford School of Public Policy, Duke University, in Durham, North Carolina, at the time this work was conducted.

William K. Bleser is a research associate in the Duke-Margolis Center for Health Policy, Duke University, in Washington, D.C.

出版信息

Health Aff (Millwood). 2019 Mar;38(3):431-439. doi: 10.1377/hlthaff.2018.05427.

Abstract

Medicaid programs are increasingly adopting incentive programs to improve health behaviors among beneficiaries. There is limited evidence on what incentives are being offered to Medicaid beneficiaries, how programs are engaging beneficiaries, and how programs are evaluated. In 2017-18 we synthesized available information on these programs and interviewed eighty policy stakeholders to identify the rationale behind key program design decisions and stakeholders' recommendations for beneficiary engagement and program evaluation. Key underlying program rationales included improving the use of preventive services and promoting personal responsibility. Beneficiary engagement strategies emphasized meeting members where they are and offering prizes or services customized for certain groups. Stakeholders recommended collaborating with external evaluators to design and conduct robust evaluations of incentive programs. Finally, stakeholders recommended aligning beneficiary incentives with provider incentives and other payment reforms through the use of common meaningful measures to streamline program evaluation.

摘要

医疗补助计划越来越多地采用激励计划来改善受益人的健康行为。关于向医疗补助受益人提供哪些激励措施、计划如何让受益人参与以及计划如何进行评估,证据有限。2017-18 年,我们综合了这些计划的可用信息,并采访了 80 名政策利益相关者,以确定关键计划设计决策背后的基本原理以及利益相关者对受益人参与和计划评估的建议。主要的基本原理包括改善预防服务的使用和促进个人责任。受益人的参与策略强调满足成员的需求,并为特定群体提供定制的奖品或服务。利益相关者建议与外部评估人员合作,设计并开展激励计划的稳健评估。最后,利益相关者建议通过使用共同的有意义的措施来简化计划评估,使受益人的激励措施与提供者的激励措施和其他支付改革保持一致。

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