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Biomedical subjects

W L Krasner

Publications and source records attributed to W L Krasner.

16 recordsLinked to original sources
PubMed1988

New directions in Medicare and Medicaid managed care.

This article summarizes major recent initiatives by the Medicare and Medicaid programs to increase the number of their beneficiaries who enroll in managed care plans. It reviews the major problems encountered to date as well as recent programmatic improvements. Finally, it offers a prognosis as to the impact of these developments on HMOs, providers, and the health care system in general.

Delivery of Health Care↗
PubMed1987

Medicare HMO risk contracts: background, problems, and prognosis.

Major changes in the Medicare program mandated by the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) became effective in 1985 and included the introduction of a capitated system for reimbursing health maintenance organizations (HMOs) for health care services provided to enrolled Medicare beneficiaries. Risk contracts with HMOs allowed the enrollment of some 900,000 individuals by May of 1987. The program has witnessed some variability in results including the Health Care Financing Administration's (HCFA's) May 1987 termination of its risk contract with International Medical Centers, Inc., a Florida-based HMO serving 150,000 subscribers, because of a number of problems, including quality of care. Recent Administration proposals would create a "private health plan option" (PHPO) with capitation and managed care provisions for all Medicare beneficiaries. This proposal would allow employers (and other entities not eligible for TEFRA risk contracts) to provide group health benefits to retirees with costs reimbursed on a capitated basis.

Capitation Fee↗
PubMedDate not supplied

Medicaid perspective.

Explore the source record for details and available documents.

Cost Control↗
PubMedDate not supplied

Healthcare reform: the strategies.

Literally dozens of comprehensive national healthcare reform bills are pending in Congress. In capsule, here are the main plans under discussion.

Financing, Organized↗