Effects of Integrating Care for Medicare-Medicaid Dually Eligible Seniors in Minnesota
Effects of Integrating Care for Medicare-Medicaid Dually Eligible Seniors in Minnesota
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DOI：
10.1080/08959420.2018.1485396
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发表时间：
2020-01-02
影响因子：
5.1
通讯作者：
Feng, Zhanlian
中科院分区：
文献类型：
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作者：
Anderson, Wayne L.;Long, Sharon K.;Feng, Zhanlian
同时有资格享受医疗保险和医疗补助的个人往往得到的是支离破碎、效率低下的医疗服务。利用明尼苏达州按服务收费的索赔、管理护理遭遇和2010-2012年的登记数据，我们估计了明尼苏达州高级健康选择（MSHO）——被视为第一个全州范围内完全整合的医疗保险-医疗补助模式——在医疗保健和长期服务以及支持使用方面的可能影响，相对于明尼苏达州高级护理+ (MSC+)，一种只有医疗补助的管理护理计划，医疗保险收费服务。估计表明，与类似的MSC+入组者相比，MSHO入组者对初级保健和社区服务的使用明显更高，同时对医院护理的使用更低。采用像MSHO这样的完全整合的护理模式可能在其他州也有价值。
Individuals dually eligible for Medicare and Medicaid often receive fragmented and inefficient care. Using Minnesota fee-for-service claims, managed care encounters, and enrollment data for 2010-2012, we estimated the likely impact of Minnesota Senior Health Option (MSHO)-seen as the first statewide fully integrated Medicare-Medicaid model-on health care and long-term services and supports use, relative to Minnesota Senior Care Plus (MSC+), a Medicaid-only managed care plan with Medicare fee for service. Estimates suggest that MSHO enrollees had significantly higher use of primary care and, potentially, of community-based services, combined with lower use of hospital-based care than similar MSC+ enrollees. Adopting fully integrated care models like MSHO may have merit in other states.