Using MEPS Data to Inform Public-Plan Consumerism

描述(由申请人提供)：为了帮助控制医疗成本，越来越多的健康保险公司和雇主正在通过“消费者驱动”的高免赔额计划应用消费主义原则。高免赔额往往伴随着健康储蓄账户，计划持有人可以用这些账户来支付可扣除的费用。2005年联邦赤字削减综合协调法案于2006年2月签署成为法律，首次将消费主义原则应用于公共计划，允许各州通过实施免赔额来修改医疗补助，并辅之以受益人将用来支付可扣除费用的“健康机会账户”(HOA)。消费主义可能会促进知情的医疗保健寻求行为，从而有助于控制医疗补助成本，但一些专家担心，免赔额将脆弱的医疗补助儿童和成人受益人置于风险之中。没有人确定哪些医疗补助受益人的医疗支出在适合医保的范围内，但却将他们置于不得不自掏腰包支付可扣除费用的低风险中。医疗支出小组调查(MEPS)数据集非常适合调查这些问题，并将允许调查人员放大这一新的联邦立法对政策制定者、医疗补助计划和受HOAS倡议影响的个人的影响。具体目标包括：(1)确定参加联邦医疗补助的儿童和成人的社会经济人口和医疗保健特征，这些儿童和成人的欧洲议会议员的支出模式表明，他们将落在医疗补助计划的可接受范围内，并且超过医疗补助拨款的可能性很低；(2)使用欧洲议会议员WAVE的两年小组格式跟踪个人随着时间的推移而对医疗补助计划的个人进行跟踪，以建立超过通过目标1确定的假设队列的医疗补助计划的医疗补助拨款的风险模型；(3)对于目标2中的模型，估计医疗补助计划的医疗补助计划的财政净影响。调查结果将与HOA项目的实施和其他消费主义努力直接相关。

DESCRIPTION (Provided by the Applicant): To help control health care costs, an increasing number of health insurers and employers are applying principles of consumerism through "consumer-driven" high-deductible plans. High deductibles are often accompanied by health savings accounts that plan holders can use to pay for deductible expenses. The federal Deficit Reduction Omnibus Reconciliation Act of 2005, signed into law in February 2006, applies principles of consumerism for the first time to public plans, by allowing states to modify Medicaid by implementing deductibles supplemented by "health opportunity accounts" (HOAs) that beneficiaries will use to pay deductible expenses. Consumerism may promote informed health care-seeking behavior and thereby help control Medicaid costs, but some experts are concerned that deductibles place vulnerable Medicaid child and adult beneficiaries at risk. No one has determined which Medicaid beneficiaries have health care expenditures within a range that would be appropriate for HOAs and yet would place them at low risk for having to pay for deductible expenses out of pocket. The Medical Expenditure Panel Survey (MEPS) dataset is ideal for investigation of these issues, and will permit the investigators to magnify the impact of this new federal legislation for policymakers, Medicaid programs, and individuals affected by the HOAs initiative. Specific aims include: (1) To identify the socio-econo-demographic and health care characteristics of children and adults enrolled in Medicaid whose expenditure patterns in MEPS indicate that they would fall within acceptable ranges for HOA programs and have low likelihood of exceeding HOA allocations; (2) To use the 2-year panel format of MEPS waves to follow individuals on Medicaid over time, to model the risk for exceeding HOA allocations for hypothetical cohorts of individuals identified through Aim #1; (3) For the models in Aim #2, to estimate the net fiscal impact of HOA initiatives for Medicaid programs. Findings will have immediate relevance for implementation of the HOA projects and other consumerism efforts.