When the price isn't right: How inadvertent payment incentives drive medical care
When the price isn't right: How inadvertent payment incentives drive medical care
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DOI：
10.1377/hlthaff.w5.376
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发表时间：
2005-09-01
期刊：
影响因子：
9.7
通讯作者：
Grossman, JM
中科院分区：
文献类型：
--
作者：
Ginsburg, PB;Grossman, JM
一些服务的意外超额支付，加上其他市场因素，正在推动昂贵护理的使用增加，这反过来可能是医疗保健成本趋势的重要驱动因素。报销制度高度依赖于提供者的收费数据，而这些数据很少提供准确和最新的相对成本指标。因此，随着时间的推移，生产率不断提高的较新服务往往利润更高。作为最大的支付者，其报销政策被私人保险公司和医疗补助计划所遵循，医疗保险可以通过采取措施使其预期支付率更准确地反映相对成本来解决这个问题。
Unintended overpayment of some services, in combination with other market factors, is driving increased use of expensive care, which in turn could be an important driver of health care cost trends. Reimbursement systems are highly dependent on provider charge data that rarely provide accurate and up-to-date indicators of relative costs. As a result, newer services, in which productivity is increasing over time, tend to be more lucrative. As the largest payer, and one whose reimbursement policies are followed by private insurers and Medicaid programs, Medicare can address this issue by taking steps to make its prospective payment rates reflect relative costs more accurately.