SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The types of health plans that may contract with Medicare have been expanded significantly. Medicare beneficiaries will have to make a determined effort to decipher the assortment of choices they now face. Health plans are required to take prescribed steps to educate Medicare beneficiaries about their choices and must contribute to cost the federal government incurs for related outreach efforts.
Explore the source record for details and available documents.
Rejecting the Clinton Administration's call for mandatory health alliances, a key congressional panel recently passed a bill that expands the Medicare program to cover low-income and uninsured Americans. While some have criticized the bill's cost-containment provisions, the panel agreed that universal coverage cannot be achieved without a national health budget.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
With the enactment of the Balanced Budget Act in 1997, the Medicare+Choice (M+C) program has been beset by plan withdrawals and declining enrollment. Despite this, M+C provides coverage to more than 12 percent of the Medicare population, a group that is disproportionately poor and minority. Under current law and the Medicare Payment Advisory Commission (MedPAC) M+C reform option, M+C enrollment will decline by one million over the next three years, while the new Bush administration proposal would stabilize program enrollment. If M+C were eliminated, nearly a third of its members would end up in traditional Medicare without any additional coverage, and 18 percent would enroll in Medicaid.
The Medicare Payment Advisory Commission (MedPAC) has identified two important problems with the Medicare+Choice (M+C) program: nationwide geographic inequity in government-financed benefits, and unequal government payments for M+C plans versus fee-for-service (FFS) Medicare in the same market area. MedPAC concludes that both problems cannot be solved simultaneously. We argue that both problems could be solved if Congress discontinued its policy of underwriting the cost of FFS Medicare. Instead, Congress should define a national entitlement benefit package and have all health plans submit bids on the package in each market area. The government's premium contribution should be equal to the lowest bid submitted by a qualified health plan in each market area. The contribution could be adjusted for health risk, the special obligations of FFS Medicare, and welfare enhancements associated with FFS Medicare that are valued by both beneficiaries and taxpayers but unrelated to beneficiaries' health status.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The authors review the financial regulations imposed on health maintenance organizations (HMOs) that participate in the Medicare+Choice program and identify elements of the regulations that may discourage HMO participation in the program. Modifications of the regulations are proposed that could encourage the participation of HMOs without affording them excessive profit. The modifications include smoothing and bounding profit estimates and authorizing and encouraging expanded use of benefit stabilization funds.
Explore the source record for details and available documents.