COST CONTAINMENT & GROUP HEALTH INSURANCE BENEFIT GROWTH

成本控制

• 批准号: 3372665
• 负责人: DOUGLAS C COATE
• 金额: $ 9.49万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-01 至 1994-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3372665
• 关键词: health care cost /financing; health care service evaluation; health insurance; managed care

The purpose of the proposed research is to evaluate the effectiveness of managed care cost containment strategies in the group health benefit plans of private and public sector employers in the U.S. Since 1987, employer sponsored group plan health insurance costs have grown at annual rates in excess of 15% after growing at well below double digit rates in the preceding three years. Have the managed care cost containment strategies celebrated in the early 1980s failed? More specifically, are health maintenance organizations, preferred provider organizations, broader use of coinsurance and deductibles, and utilization review programs ineffective in constraining the growth of employer sponsored group health plan costs? Two closely related questions to be covered in this research are: Have HMOs become a more effective cost containment option since the 1988 Health Maintenance Organization Amendments? How sensitive are the plan choices of employees (traditional indemnity, HMO, or PPO) to the contribution, deductible, and coinsurance requirements of the different plans? The data that will be analyzed are the Foster Higgins annual Health Care Benefit Surveys, 1986-1992. These surveys collectively contain data from over 4,000 public and private sector employers in the U.S. on employee health care benefit costs, on preferred provider, health maintenance organization, and flexible benefit options, on coinsurance and deductibles, and on mental and dental health coverage, home and hospice care, wellness/educational programs and other benefit characteristics that might influence group health plan costs. In addition, they contain data on the illness risk of each firm's insured employees.

拟议研究的目的是评估 团体健康福利中的管理式护理成本控制策略 美国私营和公共部门雇主的计划自1987年以来， 雇主赞助的团体计划医疗保险费用每年增长 年的增长率远低于两位数， 前三年。 管理式医疗成本控制 20世纪80年代初的战略失败了吗？具体来说， 健康维护组织，首选提供者组织， 更广泛地使用共同保险和免赔额，并审查使用情况 计划在限制雇主赞助的增长方面无效 团体健康计划的费用？两个密切相关的问题将在 这项研究是：健康维护组织是否已成为一种更有效的成本控制手段 自1988年健康维护组织修正案以来，如何 敏感的是雇员的计划选择（传统的赔偿，HMO， 或PPO）的贡献，免赔额和共同保险的要求 不同的计划？将被分析的数据是福斯特 希金斯年度保健福利调查，1986-1992年。 这些调查 数据来自4,000多个公共和私营部门 在美国的雇主对雇员的医疗保健福利费用，对首选 提供者、健康维护组织和灵活的福利选择， 共同保险和免赔额，以及精神和牙齿健康保险， 家庭和临终关怀、健康/教育方案和其他福利 可能影响团体健康计划成本的特征。 在 此外，它们还包含每家公司被保险人的疾病风险数据， 员工