Buchanan R J
Inquiry. 1983 Winter;20(4):334-42.
Payments to long-term care facilities have risen from 38% of the national Medicaid budget in 1975 to an estimated 43% during 1983. To contain these spiraling Medicaid costs and ease the fiscal burdens facing most state governments, reform of the Medicaid reimbursement system for nursing home care is essential. This study analyzes the impact of prospective rate setting by state programs on Medicaid payment and utilization rates for long-term care. For each year between 1975 and 1982, the use of prospective reimbursement was always associated with lower Medicaid payments for long-term care without adversely affecting recipient access to care.
支付给长期护理机构的费用已从1975年占国家医疗补助预算的38%升至1983年期间估计的43%。为控制这些不断攀升的医疗补助成本并减轻大多数州政府面临的财政负担，对疗养院护理的医疗补助报销系统进行改革至关重要。本研究分析了州计划的前瞻性费率设定对长期护理的医疗补助支付及利用率的影响。在1975年至1982年期间的每一年，采用前瞻性报销总是与长期护理的较低医疗补助支付相关，而不会对接受者获得护理的机会产生不利影响。
