综合初级保健加并没有提高质量或降低私人保险的支出。

Adam A Markovitz, Roslyn C Murray, Andrew M Ryan
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引用次数: 5

摘要

综合初级保健+ (CPC+)是一种多付款人支付改革模式,为初级保健实践提供激励,以降低支出和提高质量绩效。虽然CPC+已经在医疗保险中进行了评估,但对其在私营部门的影响知之甚少。利用密歇根州两家大型保险公司2013- 2020年期间的索赔和登记数据,我们进行了差异中差异分析,发现CPC+与总支出(- 44.70美元/年)或整体质量表现(-0.1个百分点)的变化无关。这些变化在CPC+队列、轨迹、地区或参与先前的初级保健创新中没有系统的变化。我们得出的结论是,CPC+并没有改善密歇根州私人计划参保人的支出或质量,甚至在向供应商支付费用之前也是如此。这一分析增加了现有的证据,即CPC+可能在短期内花费纳税人的钱,而没有伴随的护理质量的改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comprehensive Primary Care Plus Did Not Improve Quality Or Lower Spending For The Privately Insured.

Comprehensive Primary Care Plus (CPC+) was a multipayer payment reform model that provided incentives for primary care practices to lower spending and improve quality performance. Although CPC+ has been evaluated in Medicare, little is known about its impact in the private sector. Using claims and enrollment data from the period 2013-20 from two large insurers in Michigan, we performed difference-in-differences analyses and found that CPC+ was not associated with changes in total spending (-$44.70 per year) or overall quality performance (-0.1 percentage point). These changes did not vary systematically across CPC+ cohorts, tracks, regions, or participation in prior primary care innovations. We conclude that CPC+ did not improve spending or quality for private-plan enrollees in Michigan, even before accounting for payouts to providers. This analysis adds to existing evidence that CPC+ may cost payers money in the short term, without concomitant improvements to care quality.

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