Medicare HMO Enrollment Decisions in Persons with Cancer

癌症患者的 Medicare HMO 参保决定

基本信息

批准号：
6987948
负责人：
ELENA B ELKIN
金额：
$ 5.69万
依托单位：
SLOAN-KETTERING INST CAN RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-09-30 至 2007-09-29
项目状态：
已结题

项目摘要

DESCRIPTION (Provided by Applicant): Health maintenance organizations (HMOs) strive to improve disease prevention and management while containing the costs of care. However, the mechanisms they employ to achieve these goals may impede access to care and reduce satisfaction with care among persons with complex medical "conditions such as cancer. When individuals have a choice between managed care and traditional fee-for-service (FFS) health insurance, their enrollment decisions may reflect actual or perceived differences among plans with regard to quality of care, access to needed services, and overall satisfaction. In order to better understand insurance enrollment decisions in Medicare beneficiaries with serious illness, we propose to examine rates and predictors of HMO disenrollment and enrollment in beneficiaries with and without cancer. Using a population-based cancer registry linked to Medicare enrollment records, we will estimate the rates of HMO disenrollment and enrollment in a cohort of beneficiaries with cancer and a matched cohort of cancer-free beneficiaries. We will also study potential predictors of enrollment decisions, including sociodemographic, health insurance market and disease characteristics. At a time when Medicare reforms are encouraging expansion of Medicare managed care, it is crucial that we understand how Medicare HMOs and traditional FFS coverage differ with regard to the enrollment of beneficiaries with complex, chronic and costly diseases, since enrollment disparities may reflect systematic differences in quality of care and may have ramifications for the long-term financial viability of the Medicare program. Our study will provide important information regarding HMO disenrollment and enrollment among Medicare beneficiaries and the effect of a serious illness on these decisions.

描述（由申请人提供）：健康维护组织（HMO）努力改善疾病预防和管理，同时包含护理费用。但是，他们采用实现这些目标的机制可能会阻碍患有复杂医疗状况（例如癌症）的人的护理的机会，当个人在托管护理和传统的护理和传统的费用服务（FFS）健康保险（FFS）健康保险之间选择时，他们的入学率可能会反映出对医疗服务的质量，求职者的质量，可以反映出实际上或在计划中差异的实际差异。提议使用与Medicare入学记录相关的基于人群的癌症注册表的HMO剥夺和没有癌症的受益人的预测，我们将估计HMO的剥夺率和招募的癌症率。市场和疾病特征。在Medicare改革鼓励扩大Medicare托管护理的时候，至关重要的是，我们了解Medicare HMO和传统FFS的覆盖范围在患有复杂，慢性和昂贵疾病的受益人的入学率方面如何有所不同，因为招生差异可能会反映出医疗保健质量的质量差异，并且可以反映出MECTARIARE的质量差异。我们的研究将提供有关Medicare受益人中HMO剥夺和入学率以及严重疾病对这些决定的影响的重要信息。