EFFECT OF MEDICAID DRUG COPAYMENTS ON OUTCOMES AND COSTS

医疗补助药品自付额对结果和成本的影响

• 批准号: 6200302
• 负责人: NEIL JORDAN
• 金额: $ 3.24万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-07-01 至 2002-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6200302
• 关键词: Medicare /Medicaid; behavioral /social science research tag; clinical research; congestive heart failure; drug /agent; extended care; health behavior; health care cost /financing; health care policy; health care service evaluation; health care service utilization; health economics; health services research tag; heart disorder chemotherapy; human data; managed care; outcomes research; statistics /biometry

Do prescription drug copayments actually lead to higher health services utilization and costs for Medicaid beneficiaries? Prescription drug expenditures in state Medicaid programs have risen at rates far in excess of inflation during the past decade. Instituting copayments for prescription drugs has been a cost-containment strategy implemented by states, and studies suggest that beneficiary cost sharing has led to a decrease in prescription drug utilization. What is less clear is the effect of copayments on utilization of other "substitute" medical services, such as hospitalization, outpatient and physician services, and long-term care. It is also unclear if states are really saving money because the additional cost to Medicaid for these substitute medical services may exceed the drug cost savings from copayments. This study is designed to answer the following questions: * What is the impact of a drug copayment on prescription drug utilization for persons enrolled in Medicaid? * What is the association between a copayment for prescription drugs and the utilization of other medical services by Medicaid beneficiaries? * Are prescription drug copayments related to a net cost savings for a state's Medicaid program? This study will use two years of administrative data from the Health Care Financing Administration'S (HCFA's) State Medicaid Research Files and Medicare Files to evaluate the impact of drug copayments on Missouri and Minnesota Medicaid beneficiaries with congestive heart failure. Multivariate analytic techniques will be used to analyze the variation in drug and other health services utilization and expenditures. The study findings will help states assess the costs and benefits of a drug copayment policy in their Medicaid programs.

对于医疗补助受益人来说，处方药共同支付真的会导致更高的医疗服务利用率和成本吗？在过去的十年里，州医疗补助计划的处方药支出的增长速度远远超过了通货膨胀。对处方药实行共同支付一直是各州实施的一项成本控制战略，研究表明，受益人分担费用已导致处方药使用率下降。不太清楚的是，共同支付对利用其他“替代”医疗服务，如住院、门诊和医生服务以及长期护理的影响。目前还不清楚各州是否真的在省钱，因为医疗补助计划为这些替代医疗服务支付的额外费用可能超过了共同支付的药费节省。本研究旨在回答以下问题：*药物共同支付对参加医疗补助计划的人处方药使用的影响是什么？*处方药的共同支付与医疗补助受益人使用其他医疗服务之间有什么联系？*处方药共付额与州医疗补助计划的净成本节约有关吗？本研究将使用来自卫生保健财务管理局（HCFA）的国家医疗补助研究档案和医疗保险档案的两年行政数据来评估药物共同支付对密苏里州和明尼苏达州充血性心力衰竭医疗补助受益人的影响。多变量分析技术将用于分析药物和其他卫生服务的利用和支出的变化。研究结果将帮助各州评估医疗补助计划中药品共同支付政策的成本和收益。