医疗补助管理式护理需要透明度:作为蓝图的第 1115 款豁免要求。

IF 0.5 4区 社会学 Q3 LAW American Journal of Law & Medicine Pub Date : 2023-12-01 Epub Date: 2024-04-02 DOI:10.1017/amj.2024.3
Nicole Doherty
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引用次数: 0

摘要

医疗补助计划在医疗保健领域发挥着重要作用,为近四分之一的美国人口提供保险。近年来,管理性医疗机构在医疗补助领域的作用日益突出,在许多情况下,管理性医疗机构已成为医疗补助受益人的唯一保险选择。各州實施管理性護理計劃的規模和方法有很大差異。本说明讨论了各州在其医疗补助计划中实施管理性医疗的多种方法,并总结了评估此类计划成功与否所面临的挑战。它提出了管理性護理報告要求的統一方法,旨在提高各州的透明度和問責性,從而確保聯邦醫療保險管理性護理受益人獲得優質的護理。
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The Need for Transparency in Medicaid Managed Care: Section 1115 Waiver Requirements as a Blueprint.

Medicaid plays a significant role in the health care space, providing insurance coverage to nearly one quarter of the U.S. population. In recent years, managed care organizations have taken on an increasingly prominent role in the Medicaid space, and in many instances have become the sole insurance option for Medicaid recipients. The scale and method of implementation for managed care programs has varied widely from state to state. This Note discusses the many methods by which a state can enact managed care within its Medicaid program, and summarizes the challenges with assessing the success of such programs. It proposes a uniform approach to managed care reporting requirements designed to increase transparency and accountability across state lines, and in turn ensure quality care for Medicaid managed care beneficiaries.

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来源期刊
CiteScore
0.80
自引率
16.70%
发文量
8
期刊介绍: desde Enero 2004 Último Numero: Octubre 2008 AJLM will solicit blind comments from expert peer reviewers, including faculty members of our editorial board, as well as from other preeminent health law and public policy academics and professionals from across the country and around the world.
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