TITLE

Medicare's Private Plans: A Report Card On Medicare Advantage

AUTHOR(S)
Gold, Marsha
PUB. DATE
January 2009
SOURCE
Health Affairs;Jan/Feb2009, Vol. 28 Issue 1, pw41
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
With higher payments and expanded private-plan authority, Medicare Advantage (MA) has caused the market to grow. One in three Medicare beneficiaries with Part D now gets this coverage through MA. Analysis of the sources of and reasons for enrollment growth suggest a troubling report card. Clearly, the Medicare Modernization Act (MMA) has expanded choice and the private-sector role. But it also has added to Medicare's complexity and costs and has created potential inequities, without apparent improvements in quality. However the debate ends, a stronger system of performance monitoring and accountability is needed to meet Medicare's essential fiduciary requirements and oversight responsibilities.
ACCESSION #
36066157

 

Related Articles

  • Medicare Calibration of the Clinically Detailed Risk Information System for Cost. Kapur, Kanika; Chien-Wen Tseng; Rastegar, Afshin; Carter, Grace M.; Keeler, Emmett // Health Care Financing Review;Fall2003, Vol. 25 Issue 1, p37 

    The clinically detailed risk information system for cost (CD-RISC) contains definitions for several hundred severity-adjusted conditions that can be used to predict future health care costs. We develop a prospective Medicare CD-RISC model using a 5-percent sample of Medicare beneficiaries and...

  • SPECIAL REPORT: Defining A Future For Fee-For-Service Medicare. Foote, Susan Bartlett; Halaas, Gwen Wagstrom // Health Affairs;May/Jun2006, Vol. 25 Issue 3, p864 

    The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) provides economic incentives that favor health plans over traditional fee-for-service (FFS) Medicare. This reflects an ideological preference for private plans rather than government- administered pricing and recognition...

  • Capping drug benefits does not reduce total medical costs.  // PharmacoEconomics & Outcomes News;6/17/2006, Issue 505, p4 

    The article discusses research being done on the total medical costs of patients whose drug benefits were capped and those whose benefits were not capped. It references a study by J. Hsu and colleagues in the June 2006 issue of the "New England Journal of Medicine." The researchers used a...

  • How Much 'Skin In The Game' Do Medicare Beneficiaries Have? The Increasing Financial Burden Of Health Care Spending, 1997-2003. Neuman, Patricia; Cubanski, Juliette; Desmond, Katherine A.; Rice, Thomas H. // Health Affairs;Nov/Dec2007, Vol. 26 Issue 6, p1692 

    Rising health costs and an aging population present critical policy challenges. This paper examines the financial burden of out-of-pocket health spending among Medicare beneficiaries between 1997 and 2003. Over this period, median out-of-pocket spending as a share of income increased from 11.9...

  • Use of Costly Breast Cancer Therapy Influenced Strongly by Reimbursement Policy and Practice Setting.  // JNCI: Journal of the National Cancer Institute;May2011, Vol. 103 Issue 10, pNP 

    The article focuses on a study that examined the factors associated with billing for intensity-modulated radiation therapy (IMRT) in Medicare beneficiaries with breast cancer in the U.S. It provides a comparison between the average cost of radiation within the first year of diagnosis with and...

  • Distribution of Medicare Cost-Sharing Liability.  // Health Care Financing Review;Summer94 Supplement, Vol. 15, p44 

    The article provides information on the distribution of Medicare cost-sharing liability among Medicare beneficiaries in the United States. In 1992, an estimated 27.9 million Medicare beneficiaries used covered services and incurred cost-sharing liability amounting to $21.7 billion, an average...

  • Longevity and Health Care Expenditures: The Real Reasons Older People Spend More. Zhou Yang; Norton, Edward C.; Stearns, Sally C. // Journals of Gerontology Series B: Psychological Sciences & Socia;Jan2003, Vol. 58 Issue 1, pS2 

    Objectives. In this study, we investigated the relative contributions of both age and time to death to health care expenditures for elderly Medicare beneficiaries. We also analyzed differences in expenditure patterns by age and time to death for various service types and payers. Methods. We...

  • Spending and Quality of Care for Medicare Beneficiaries in Massachusetts. Brown, Jeffrey // JAMA: Journal of the American Medical Association;12/25/2013, Vol. 310 Issue 24, p2674 

    A letter to the editor is presented in response to the article "Changes in Health Care Spending and Quality for Medicare Beneficiaries Associated with a Commercial ACO Contract," by J. M. McWilliams et al. in a 2013 issue.

  • Spending and Quality of Care for Medicare Beneficiaries in Massachusetts. McWilliams, J. Michael; Landon, Bruce E.; Chernew, Michael E. // JAMA: Journal of the American Medical Association;12/25/2013, Vol. 310 Issue 24, p2675 

    A response from the author of the article "Changes in Health Care Spending and Quality for Medicare Beneficiaries Associated with a Commercial ACO Contract," in a 2013 issue is presented.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics