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首页> 外文期刊>The American journal of hospice & palliative medicine >Medicare as Insurance Innovator: The Case of Hospice
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Medicare as Insurance Innovator: The Case of Hospice

机译:医疗保险作为保险创新者:临终关怀案例

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摘要

The stylized fact is that while private insurance has tended to innovate on the benefit design side of the insurance contract, Medicare has lead innovation on the payment side. Traditional or Fee-For-Service Medicare has produced many innovations in the payment for health care services, such as Prospective Payment for hospitals, Diagnostic-Related Groups to categorize care, and the Resource-Based Relative Value System used by the program to pay physicians, while private insurance has produced a series of benefit design innovations. This story misses one important example of Medicare benefit innovation: the creation of the Medicare hospice benefit. A key question is whether Medicare can again lead a system-wide benefit design effort to improve upon current hospice and palliative care policy.
机译:程式化的事实是,尽管私人保险倾向于在保险合同的利益设计方面进行创新,但医疗保险在支付方面却处于领先地位。传统医疗服务或按服务付费医疗保险在医疗服务支付方面产生了许多创新,例如医院的预期支付,对医疗进行分类的诊断相关小组以及该计划用来支付医师费用的基于资源的相对价值系统,而私人保险则带来了一系列福利设计创新。这个故事错过了Medicare福利创新的一个重要例子:Medicare临终关怀福利的创建。一个关键问题是,Medicare是否可以再次领导整个系统的福利设计工作,以改善当前的临终关怀和姑息治疗政策。

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