Trends In Medicare Fee-For-Service Spending Growth For Dual-Eligible Beneficiaries, 2007-15
Trends In Medicare Fee-For-Service Spending Growth For Dual-Eligible Beneficiaries, 2007-15
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DOI：
10.1377/hlthaff.2018.0143
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发表时间：
2018-08-01
期刊：
影响因子：
9.7
通讯作者：
Buntin, Melinda B.
中科院分区：
文献类型：
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作者：
Keohane, Laura M.;Stevenson, David G.;Buntin, Melinda B.
双重资格受益人（参加医疗保险和医疗补助的人）的成本控制是一个关键的政策目标，但很少有研究审查这一人群的支出趋势。我们对比了2007- 2015年期间有和没有医疗补助的人的医疗保险服务费的增长。相对于只参加医疗保险的人，双重资格的受益人始终有更高的整体医疗保险支出水平;然而，他们在研究期间经历了支出增长的急剧下降。这些趋势在关注人群中各不相同。例如，65岁及以上的双重资格受益人的年支出增长率从2008年比仅医疗保险受益人高1.8个百分点下降到2015年的1.1个百分点。在整个人口群体中，长期使用养老院护理的人的支出增长率最高，根据年龄组和医疗补助的参与情况，平均每年增长1.7%-4.1%。这些发现对基于价值的支付和其他旨在控制双重资格受益人支出的医疗保险政策具有影响。
Cost containment for dual-eligible beneficiaries (those enrolled in Medicare and Medicaid) is a key policy goal, but few studies have examined spending trends for this population. We contrasted growth in Medicare fee-for-service per beneficiary spending for those with and without Medicaid in the period 2007-15. Relative to Medicare-only enrollees, dual-eligible beneficiaries consistently had higher overall Medicare spending levels; however, they experienced steeper declines in spending growth over the study period. These trends varied across populations of interest. For instance, dual-eligible beneficiaries ages sixty-five and older went from having annual spending growth rates that were 1.8 percentage points higher than Medicare-only beneficiaries in 2008 to rates that were 1.1 percentage points lower in 2015. Across population groups, long-term users of nursing home care had some of the highest spending growth rates, averaging 1.7-4.1 percent annually depending on age group and Medicaid participation. These findings have implications for value-based payment and other Medicare policies aimed at controlling spending for dual-eligible beneficiaries.