Cooper B
Office of Strategic Planning, Health Care Financing Administration, Baltimore, Maryland 21244, USA.
Clin Ther. 1998 Nov-Dec;20(6):1241-9. doi: 10.1016/s0149-2918(98)80119-7.
Medicare managed care enrollment has mushroomed in the past few years, tripling from 1993 to 1997. The payment rates have allowed plans to offer valuable extra benefits to beneficiaries at little or no additional cost; employers have provided inducements for their retirees to enroll; and many of the new Medicare beneficiaries are already in managed care plans when they enter the program. The Balanced Budget Act of 1997 and other factors could cause enrollment trends to change in either direction. More kinds of plans, including physician service organizations and preferred provider organizations, may be more attractive; new educational efforts may make more beneficiaries aware of managed care plans; and employers may continue to move their retirees into managed care. On the other hand, lower than expected Medicare payment rates to the plans may reduce the additional benefits they offer; consumer dissatisfaction with managed care is growing; and employers are dropping retiree benefits altogether. The future of Medicare managed care is hard to predict.
在过去几年中，医疗保险管理式医疗的参保人数迅速增长，从1993年到1997年增长了两倍。支付率使各计划能够以很少或无需额外成本为受益人提供有价值的额外福利；雇主为其退休人员参保提供了诱因；许多新加入医疗保险的受益人在进入该计划时就已参加了管理式医疗计划。1997年的《平衡预算法案》及其他因素可能导致参保趋势朝任一方向变化。更多类型的计划，包括医师服务组织和优选提供者组织，可能更具吸引力；新的教育举措可能会让更多受益人了解管理式医疗计划；雇主可能会继续将其退休人员转入管理式医疗。另一方面，医疗保险向各计划支付的费用低于预期，可能会减少它们提供的额外福利；消费者对管理式医疗的不满情绪在增加；雇主们则完全取消了退休人员福利。医疗保险管理式医疗的未来难以预测。
