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DISSEMINATING INFORMATION ON THE QUALITY OF HMOS

传播有关 HMOS 质量的信息

基本信息

批准号：
2904473
负责人：
ZHE JIN
金额：
$ 3.18万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-07-01 至 2000-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2904473
关键词：
Medicare /Medicaid decision making health care policy health care quality health insurance health services research tag human data information dissemination managed care

项目摘要

As the leading private agency dedicated to assessing and reporting managed care quality information, the National Committee of Quality Assurance (NCQA) began providing accreditation to health maintenance organizations (HMOs) in 1991 and has publicized HMO performance data since 1993. The apparent success of NCQA has focused attention on how HMO quality is measured and how this affects individuals' choice of health plans. On this issue, it is important to note that both accreditation and performance data reporting are voluntary. Indeed, as of June 1, 1998, more than half of all operating HMOs remain non-accredited and/or withhold data from the NCQA. It is not clear what conclusions about quality consumers have drawn from these non-accredited or non-reporting HMO statuses. The purpose of this study is to present and analyze empirical evidence on why HMOs are willing or not willing to voluntarily disseminate quality information through the NCQA and whether the NCQA information affects consumers' choice of HMOs. Using the plan-level time series data from Medicare and the Federal Employee Health Benefits Program (FEHBP), my dissertation first estimates the impact of the NCQA information on the health plan enrollment in these two programs. The second task is to test whether the unequal access of quality information in Medicare and FEHBP leads to different consumer response. Finally, the study investigates to what extent HMOs adopt the voluntary information disclosure as a strategic response to the demand and to the competition in cost and quality.

作为致力于评估和报告管理式护理质量信息的领先私营机构，国家质量保证委员会（NCQA）于1991年开始为健康维护组织（HMO）提供认证，并自1993年以来公布了HMO的绩效数据。 NCQA的明显成功将注意力集中在如何衡量HMO质量以及这如何影响个人对健康计划的选择上。在这个问题上，必须指出，认证和业绩数据报告都是自愿的。事实上，截至1998年6月1日，超过一半的健康维护组织仍然没有得到认证和/或拒绝向NCQA提供数据。目前尚不清楚从这些未经认证或未报告的HMO状态中得出的关于质量消费者的结论。本研究的目的是提出和分析经验证据，为什么卫生组织愿意或不愿意自愿传播质量信息，通过NCQA和NCQA信息是否影响消费者的选择卫生组织。使用来自医疗保险和联邦员工健康福利计划（FEHBP）的计划级时间序列数据，我的论文首先估计NCQA信息对这两个计划中健康计划注册的影响。第二个任务是测试医疗保险和FEHBP中质量信息的不平等获取是否会导致不同的消费者反应。最后，本研究探讨卫生组织在何种程度上采用自愿性信息披露作为对需求和成本和质量竞争的战略反应。