Medicare Advantage: Déjà Vu All Over Again?

Biles, Brian; Dallek, Geraldine; Nicholas, Lauren Hersch
July 2004
Health Affairs;Jul-Dec2004 Supplement 2, Vol. 23, p586
Academic Journal
The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 expands the role of private health plans in Medicare through prescription drug plans and a revised Medicare+Choice (M+C), renamed Medicare Advantage, program. This paper discusses the factors responsible for the failure of M+C to develop as intended in 1997 and analyzes the challenges for MMA implementation in light of these factors. They include making a complex program understandable to beneficiaries; addressing plans' efforts to avoid enrolling high-cost beneficiaries; ensuring stability of benefits, providers, and plans; dealing with beneficiaries enrolled in unsuitable plans; providing equity of health benefits throughout the country; and controlling overall Medicare costs.


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