McBride T D
University of Missouri-St. Louis, USA.
Health Aff (Millwood). 1998 Nov-Dec;17(6):170-80. doi: 10.1377/hlthaff.17.6.170.
Concern about the variation in rates paid to Medicare managed care plans across the United States led to the passage of major reforms of formulas for setting these rates as part of the Balanced Budget Act (BBA) of 1997. However, observers have focused much more on the variation in the rates per se than on the disparity in benefits offered by these plans and in the premiums they charge. This analysis shows that there is considerable variation in the range of risk plans available to Medicare beneficiaries, the premiums charged, and the benefits offered and that the variation is strongly related to the payment made by the Health Care Financing Administration (HCFA) on behalf of the beneficiary and to the beneficiary's area of residence.
对美国医疗保险管理式医疗计划支付费率差异的担忧,促使作为1997年《平衡预算法案》(BBA)一部分的这些费率设定公式进行了重大改革。然而,观察人士更多地关注费率本身的差异,而非这些计划提供的福利以及它们收取的保费之间的差异。该分析表明,医疗保险受益人可获得的风险计划范围、收取的保费以及提供的福利存在相当大的差异,并且这种差异与医疗保健财务管理局(HCFA)代表受益人支付的费用以及受益人的居住地区密切相关。