Medicare Advantage Plan Double Bonuses Drive Racial Disparity In Payments, Yield No Quality Or Enrollment Improvements.
Medicare Advantage Plan Double Bonuses Drive Racial Disparity In Payments, Yield No Quality Or Enrollment Improvements.
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医疗保险优势计划双重奖金驱动种族差异支付，产量没有质量或招生改善。
DOI：
10.1377/hlthaff.2021.00349
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发表时间：
2021-09
期刊：
影响因子：
9.7
通讯作者：
Ryan, Andrew M.
中科院分区：
文献类型：
--
作者：
Markovitz, Adam A.;Ayanian, John Z.;Warrier, Anupama;Ryan, Andrew M.
根据2012年启动的医疗保险优势质量奖金支付计划，在合格县的MA计划，具有相对较高的质量表现，并位于被认为合格的县，获得的质量奖金是不合格县的两倍。相对于不合格的县，合格的县有更多的人口和更高的MA入学率。使用2008年至2018年的国家数据，我们发现双重奖金与更高的计划质量或增加的入学率无关。此外，由于黑人受益人不太可能居住在符合条件的县，双重奖金支付增加了60美元，每年为黑人注册60美元，而白色注册91美元。我们的研究结果表明，双重奖金不仅在实现预期的改善无效，而且还促进了医疗保险基金的种族不公平分配，不利于黑人MA注册者。我们的研究支持取消双重奖金，估计每年节省17亿美元。
Under the Medicare Advantage Quality Bonus Payment Program, initiated in 2012, MA plans in eligible counties, with relatively high quality performance, and located in counties deemed eligible, receive quality bonuses twice as large as counterparts in doubling-ineligible counties. Relative to ineligible counties, eligible counties have larger populations and higher MA enrollment. Using national data for 2008 through 2018, we found double bonuses were not associated with either higher plan quality or increased enrollment. Additionally, because Black beneficiaries were less likely to reside in eligible counties, double bonus payments increased spending by $60 per year for Black enrollees $60, compared to $91 for White enrollees. Our findings suggest double bonuses are not only ineffective in achieving desired improvements, but also foster racially inequitable distribution of Medicare funds that disfavors Black MA enrollees. Our study supports eliminating double bonuses, saving an estimated $1.7 billion per year.
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影响因子：
3.4
作者：
WHITEHEAD, M
通讯作者：
WHITEHEAD, M
影响因子：
3.4
作者：
McGarry, Brian E.;Layton, Timothy J.;Grabowski, David C.
通讯作者：
Grabowski, David C.
影响因子：
158.5
作者：
Ayanian, John Z.;Landon, Bruce E.;Zaslavsky, Alan M.
通讯作者：
Zaslavsky, Alan M.
DOI：
10.1377/hlthaff.2021.00118
发表时间：
2021-06
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Meyers DJ;Mor V;Rahman M;Trivedi AN
通讯作者：
Trivedi AN
影响因子：
7.7
作者：
Barnett, AG;van der Pols, JC;Dobson, AJ
通讯作者：
Dobson, AJ