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医生对商业医疗保险和医疗补助管理式医疗计划的看法:一项比较研究。

Physicians' perceptions of commercial and Medicaid managed care plans: a comparison.

作者信息

Silverstein G

出版信息

J Health Polit Policy Law. 1997 Feb;22(1):5-21. doi: 10.1215/03616878-22-1-5.

Abstract

Physician participation in fee-for-service Medicaid programs has been declining nationally since the mid-1970s. Numerous studies have documented the reasons for this decline, including poor reimbursement, payment delays, and administrative burdens. Most are now incorporating managed care into their Medicaid programs as an approach to reduce costs. Arizona has the only statewide, mandatory managed care Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS). This study examines Arizona physicians' perceptions of both AHCCCS and commercial managed care plans. If physicians' perceptions of commercial and Medicaid managed care plans are similar, as suggested by this study, then recruitment of physicians into Medicaid programs should improve during the coming years in geographic areas that have some managed care penetration.

摘要

自20世纪70年代中期以来,全国范围内医生参与按服务收费的医疗补助计划的比例一直在下降。许多研究记录了这种下降的原因,包括报销不足、付款延迟和行政负担。现在大多数地区都将管理式医疗纳入其医疗补助计划,作为降低成本的一种方式。亚利桑那州拥有唯一的全州强制性管理式医疗医疗补助计划,即亚利桑那医疗成本控制系统(AHCCCS)。本研究考察了亚利桑那州医生对AHCCCS和商业管理式医疗计划的看法。如果本研究表明医生对商业和医疗补助管理式医疗计划的看法相似,那么在未来几年,在有一定管理式医疗渗透率的地理区域,招募医生加入医疗补助计划的情况应该会有所改善。

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