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首页> 美国卫生研究院文献>American Journal of Public Health >Service use and costs for Medicare beneficiaries in risk-based HMOs and CMPs: some interim results from the National Medicare Competition Evaluation.
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Service use and costs for Medicare beneficiaries in risk-based HMOs and CMPs: some interim results from the National Medicare Competition Evaluation.

机译：基于风险的HMO和CMP中医疗保险受益人的服务使用和费用：国家医疗保险竞争评估的一些中期结果。

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The Health Care Financing Administration (HCFA) initiated the Medicare Competition Demonstration in 1982 in anticipation of congressional intent to establish a national program. Interim results on the 1984 service use and cost experience of the health maintenance organizations (HMOs) and competitive medical plans (CMPs) participating in the demonstrations indicate that Medicare enrollees in the demonstration experienced a median of 1,951 hospital days per 1,000 person years, 57 per cent of the median of 3,432 days per 1,000 in the local markets from which the plans drew enrollment. Independent practice association (IPA) HMOs experienced higher hospital use rates than staff and group model HMOs. These comparisons are not adjusted for various risk factors, the absence of which were likely to favor the demonstration plans. Plans with lower hospital service use were federally qualified and had been operating for more than five years. The median total annual revenue per enrollee across all plans was $2,312, compared to median annual expenses per enrollee of $2,250. The distribution of median annual expenses per enrollee by major category of expense was: institutional expenses ($1,038/enrollee), medical expenses ($720/enrollee), supplemental services expenses ($154/enrollee), and administrative and other expenses ($295/enrollee). Future analysis, using beneficiary-level data, will examine the impact of the demonstration and the nature and extent of evident biased selection and will compare the quality of care in the demonstrations to that in the fee-for-service sector.
机译：卫生保健筹资管理局（HCFA）于1982年启动了Medicare竞赛示范，以期望国会有意建立一个国家计划。参加示威活动的1984年卫生维护组织（HMO）和竞争性医疗计划（CMP）的服务使用和成本经验的中期结果表明，参加示威活动的Medicare参与者的中位数为每1000人年1,951医院天，每千人年57天计划吸引的本地市场每千名中位数3,432天的中位数的百分之一。独立执业协会（IPA）HMO的住院使用率高于员工和团体HMO。这些比较未针对各种风险因素进行调整，没有这些风险因素可能会有利于示范计划。减少医院服务使用的计划具有联邦资格，并且已经运行了五年以上。在所有计划中，每位注册者的年总收入中位数为2,312美元，而每位注册者的年均支出中位数为2,250美元。按主要费用类别划分的每个注册人的年平均费用分布为：机构费用（1,038美元/注册人），医疗费用（720美元/注册人），补充服务费用（154美元/注册人）以及行政和其他费用（295美元/注册人） 。未来的分析将使用受益人级别的数据，检查示威活动的影响以及明显偏向选择的性质和程度，并将示威活动与收费服务部门的护理质量进行比较。

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