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Stuart Guterman

Publications and source records attributed to Stuart Guterman.

3 recordsLinked to original sources

The cost of privatization: extra payments to Medicare Advantage plans--updated and revised.

The Medicare Modernization Act of 2003 sharply increased payments to private Medicare Advantage plans. As a result, every plan in every county in the nation was paid more in 2005 than its enrollees would have been expected to cost if they had been enrolled in traditional fee-for-service Medicare. The authors calculate that payments to Medicare Advantage plans averaged 12.4 percent more than costs in traditional Medicare during 2005: a total of more than $5.2 billion, or $922 for each of the 5.6 million Medicare enrollees in managed care. This issue brief updates an earlier analysis of Medicare Advantage payments in 2005 previously published by The Commonwealth Fund; the updated estimates in this report are based on final 2005 enrollment figures that were not available at the time the previous estimates were developed, and they include the effect of policy decisions that were not reflected in the previous estimates.

Costs and Cost Analysis↗

Financing teaching hospital missions: a context.

The issue of what teaching hospitals do, how much it costs, and how it should be financed has been the subject of ongoing debate. This Perspective provides a context for considering the implications of the latest contribution to that debate: the paper by Lane Koenig and colleagues that presents new estimates of teaching hospitals' mission-related costs. I address the system through which teaching hospital activities are financed, the difficulty in identifying and estimating the costs of teaching hospitals' missions, and the problems involved in determining how those missions should be underwritten.

Education, Medical, Graduate↗

Specialty hospitals: a problem or a symptom?

The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 imposed a moratorium on new physician-owned specialty hospitals, which expired in June 2005. Recent administrative decisions have effectively extended the moratorium as it applies to Medicare payment, and the debate continues over whether specialty hospitals are good, bad, or indifferent. This paper reviews the findings in two congressionally mandated reports on specialty hospitals, the services they provide, and their impact on their patients and communities. These findings are used to highlight the major policy issues to be addressed-issues that go beyond whether specialty hospitals should be allowed.

Hospitals, Special↗