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综合性初级保健加并没有改善私人保险的质量或降低支出。

Comprehensive Primary Care Plus Did Not Improve Quality Or Lower Spending For The Privately Insured.

机构信息

Adam A. Markovitz, University of Michigan, Ann Arbor, Michigan.

Roslyn C. Murray, University of Michigan.

出版信息

Health Aff (Millwood). 2022 Sep;41(9):1255-1262. doi: 10.1377/hlthaff.2021.01982.

Abstract

Comprehensive Primary Care Plus (CPC+) was a multipayer payment reform model that provided incentives for primary care practices to lower spending and improve quality performance. Although CPC+ has been evaluated in Medicare, little is known about its impact in the private sector. Using claims and enrollment data from the period 2013-20 from two large insurers in Michigan, we performed difference-in-differences analyses and found that CPC+ was not associated with changes in total spending (-$44.70 per year) or overall quality performance (-0.1 percentage point). These changes did not vary systematically across CPC+ cohorts, tracks, regions, or participation in prior primary care innovations. We conclude that CPC+ did not improve spending or quality for private-plan enrollees in Michigan, even before accounting for payouts to providers. This analysis adds to existing evidence that CPC+ may cost payers money in the short term, without concomitant improvements to care quality.

摘要

综合初级保健加(CPC+)是一种多付款人支付改革模式,为初级保健实践提供激励,以降低支出并提高质量绩效。尽管 CPC+已在医疗保险中进行了评估,但在私营部门的影响知之甚少。我们使用密歇根州两家大型保险公司在 2013-20 年期间的索赔和参保数据,进行了差异分析,发现 CPC+与总支出变化(每年减少 44.70 美元)或整体质量绩效(无变化)无关。这些变化在 CPC+队列、轨道、地区或之前参与初级保健创新方面没有系统差异。我们的结论是,即使在不考虑向提供者支付款项的情况下,CPC+也没有改善密歇根州私人计划参保者的支出或质量。这项分析增加了现有证据,表明 CPC+可能会在短期内使支付者花钱,而不会同时提高护理质量。

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