为什么不给慢性病患者最好的呢?

S B Jones
{"title":"为什么不给慢性病患者最好的呢?","authors":"S B Jones","doi":"10.1080/0742-969x.1998.11882891","DOIUrl":null,"url":null,"abstract":"<p><p>Premium adjustors to neutralize risk selection among health plans are the weakest component in the technology for assuring competitive markets. It will be many years before we have adjustors adequate to free health plans to invest in and market improved managed care to predictably high-cost chronically ill persons. For want of a fair premium, health plans are driven by risk selection to underinvest in and otherwise \"demarket\" care to these very employees and beneficiaries whose costs and care most need to be managed. To achieve best value for the chronically ill, large employer coalitions, Medicare, and Medicaid should consider radical new approaches, such as establishing separate prices for care to people with specific chronic conditions and purchasing such care both from health plans and directly from provider systems.</p>","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"13 1-2","pages":"101-15"},"PeriodicalIF":0.0000,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0742-969x.1998.11882891","citationCount":"6","resultStr":"{\"title\":\"Why not the best for the chronically ill?\",\"authors\":\"S B Jones\",\"doi\":\"10.1080/0742-969x.1998.11882891\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Premium adjustors to neutralize risk selection among health plans are the weakest component in the technology for assuring competitive markets. It will be many years before we have adjustors adequate to free health plans to invest in and market improved managed care to predictably high-cost chronically ill persons. For want of a fair premium, health plans are driven by risk selection to underinvest in and otherwise \\\"demarket\\\" care to these very employees and beneficiaries whose costs and care most need to be managed. To achieve best value for the chronically ill, large employer coalitions, Medicare, and Medicaid should consider radical new approaches, such as establishing separate prices for care to people with specific chronic conditions and purchasing such care both from health plans and directly from provider systems.</p>\",\"PeriodicalId\":77421,\"journal\":{\"name\":\"The Hospice journal\",\"volume\":\"13 1-2\",\"pages\":\"101-15\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1998-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1080/0742-969x.1998.11882891\",\"citationCount\":\"6\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Hospice journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/0742-969x.1998.11882891\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Hospice journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/0742-969x.1998.11882891","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 6

摘要

在确保竞争市场的技术中,用于中和健康计划之间风险选择的保费调整是最薄弱的部分。我们还需要许多年的时间才能有足够的调整机构来免费投资健康计划,并向可预见的高成本慢性病患者推销改进的管理式医疗。由于缺乏公平的保费,健康计划受到风险选择的驱动,对这些成本和护理最需要管理的雇员和受益人投资不足,或者“去市场化”医疗服务。为了实现慢性病患者的最佳价值,大型雇主联盟、医疗保险和医疗补助应该考虑激进的新方法,例如为患有特定慢性病的人建立单独的医疗价格,并从健康计划和直接从提供者系统中购买此类医疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Why not the best for the chronically ill?

Premium adjustors to neutralize risk selection among health plans are the weakest component in the technology for assuring competitive markets. It will be many years before we have adjustors adequate to free health plans to invest in and market improved managed care to predictably high-cost chronically ill persons. For want of a fair premium, health plans are driven by risk selection to underinvest in and otherwise "demarket" care to these very employees and beneficiaries whose costs and care most need to be managed. To achieve best value for the chronically ill, large employer coalitions, Medicare, and Medicaid should consider radical new approaches, such as establishing separate prices for care to people with specific chronic conditions and purchasing such care both from health plans and directly from provider systems.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信