Intrator O, Mor V, Hines M A, Lancaster T, Laliberte L L, Freiberger W
Statistics Department, Hebrew University, USA.
Inquiry. 1996 Spring;33(1):42-52.
The Medicare Catastrophic Coverage Act (MCCA) of 1989 was designed to expand Medicare's post-acute care benefits, reduce copayments, and raise the asset limit for Medicaid eligibility. This analysis uses a semi-Markov transition model to estimate the effect of the MCCA on changes to Medicare coverage and the spend-down rate among 5,551 new nursing home admissions followed for an average of 2.5 years. We found that Medicare use increased in 1989 and the risk of transiting from Medicare to self-pay decreased compared to 1988. Spend-down from self-pay to Medicaid was 60% more likely in 1990. The MCCA clearly increased access to Medicare coverage of nursing home care among individuals previously paying privately.
1989年的《医疗保险灾难性保险法案》（MCCA）旨在扩大医疗保险的急性后期护理福利，降低自付费用，并提高医疗补助资格的资产限额。本分析使用半马尔可夫转移模型来估计MCCA对医疗保险覆盖范围变化以及5551名新入住疗养院患者（平均随访2.5年）的自费率的影响。我们发现，与1988年相比，1989年医疗保险的使用增加，从医疗保险转为自费的风险降低。1990年，从自费转为医疗补助的可能性增加了60%。MCCA显然增加了以前自费支付的个人获得疗养院护理医疗保险覆盖的机会。
