联邦黑肺福利计划支付的医疗保险索赔:1999-2016年美国医疗保险受益人。

L. Kurth, M. Casey, P. Schleiff, Cara N Halldin, J. Mazurek, D. Blackley
{"title":"联邦黑肺福利计划支付的医疗保险索赔:1999-2016年美国医疗保险受益人。","authors":"L. Kurth, M. Casey, P. Schleiff, Cara N Halldin, J. Mazurek, D. Blackley","doi":"10.1097/JOM.0000000000001745","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\nTo establish the burden of totally disabling respiratory impairment among coal miners, we identified the healthcare utilization and cost for Medicare claims where the Federal Black Lung Program (FBLP) was the primary payer.\n\n\nMETHODS\nWe extracted FBLP claims from 1999-2016 institutional Medicare data along with beneficiary, comorbidity, and claim cost information. Healthcare utilization was evaluated and compared to the 2016 Medicare population.\n\n\nRESULTS\nThe FBLP was the primary payer on 75,690 claims from 19,700 beneficiaries and paid an increasing percentage of the total paid to providers annually. Claims decreased from 1999-2016 but cost per claim increased. Beneficiaries were hospitalized and visited the ER for respiratory and cardiovascular conditions.\n\n\nCONCLUSIONS\nMedicare beneficiaries with FBLP primary payer claims have higher healthcare utilization and comorbidities compared to Medicare enrollees, indicative of increased financial and healthcare burden.","PeriodicalId":46545,"journal":{"name":"International Journal of Occupational and Environmental Medicine","volume":"71 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"Medicare claims paid by the Federal Black Lung Benefits Program: U.S. Medicare Beneficiaries, 1999-2016.\",\"authors\":\"L. Kurth, M. Casey, P. Schleiff, Cara N Halldin, J. Mazurek, D. Blackley\",\"doi\":\"10.1097/JOM.0000000000001745\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE\\nTo establish the burden of totally disabling respiratory impairment among coal miners, we identified the healthcare utilization and cost for Medicare claims where the Federal Black Lung Program (FBLP) was the primary payer.\\n\\n\\nMETHODS\\nWe extracted FBLP claims from 1999-2016 institutional Medicare data along with beneficiary, comorbidity, and claim cost information. Healthcare utilization was evaluated and compared to the 2016 Medicare population.\\n\\n\\nRESULTS\\nThe FBLP was the primary payer on 75,690 claims from 19,700 beneficiaries and paid an increasing percentage of the total paid to providers annually. Claims decreased from 1999-2016 but cost per claim increased. Beneficiaries were hospitalized and visited the ER for respiratory and cardiovascular conditions.\\n\\n\\nCONCLUSIONS\\nMedicare beneficiaries with FBLP primary payer claims have higher healthcare utilization and comorbidities compared to Medicare enrollees, indicative of increased financial and healthcare burden.\",\"PeriodicalId\":46545,\"journal\":{\"name\":\"International Journal of Occupational and Environmental Medicine\",\"volume\":\"71 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Occupational and Environmental Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/JOM.0000000000001745\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Occupational and Environmental Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/JOM.0000000000001745","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 2

摘要

目的了解煤矿工人完全致残性呼吸障碍的负担情况,确定以联邦黑肺计划(FBLP)为主要付款人的医疗保险理赔的医疗保健利用情况和费用。方法:我们从1999-2016年机构医疗保险数据中提取FBLP索赔,以及受益人、合并症和索赔成本信息。评估医疗保健利用情况,并与2016年医疗保险人口进行比较。结果FBLP是19,700名受益人中75,690项索赔的主要付款人,每年支付给提供者的总付款比例不断增加。从1999年到2016年,索赔有所下降,但每笔索赔的成本有所增加。受益人因呼吸和心血管疾病住院并到急诊室就诊。结论FBLP主要付款人索赔的医疗保险受益人与医疗保险参保人相比有更高的医疗保健利用率和合并症,表明经济和医疗负担增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Medicare claims paid by the Federal Black Lung Benefits Program: U.S. Medicare Beneficiaries, 1999-2016.
OBJECTIVE To establish the burden of totally disabling respiratory impairment among coal miners, we identified the healthcare utilization and cost for Medicare claims where the Federal Black Lung Program (FBLP) was the primary payer. METHODS We extracted FBLP claims from 1999-2016 institutional Medicare data along with beneficiary, comorbidity, and claim cost information. Healthcare utilization was evaluated and compared to the 2016 Medicare population. RESULTS The FBLP was the primary payer on 75,690 claims from 19,700 beneficiaries and paid an increasing percentage of the total paid to providers annually. Claims decreased from 1999-2016 but cost per claim increased. Beneficiaries were hospitalized and visited the ER for respiratory and cardiovascular conditions. CONCLUSIONS Medicare beneficiaries with FBLP primary payer claims have higher healthcare utilization and comorbidities compared to Medicare enrollees, indicative of increased financial and healthcare burden.
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
International Journal of Occupational and Environmental Medicine
International Journal of Occupational and Environmental Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
13.80
自引率
0.00%
发文量
0
审稿时长
18 weeks
期刊最新文献
The Use of Metabolomic Tool in Assessing Environmental Exposure Fine and Ultrafine Particle Pollution Before and After a Smoking ban in the Catering Industry in Vienna Investigating the level of Safety Considerations in Radiology Centers (North of Iran): Cross –Sectional Study New Highlights. The Last Note.
×
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
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 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 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1