medicare part c
Summary: The Balanced Budget Act (BBA) of 1997 establishes a Medicare+Choice program under part C of Title XVIII, Section 4001, of the Social Security Act. Under this program, an eligible individual may elect to receive Medicare benefits through enrollment in a Medicare+Choice plan. Beneficiaries may choose to use private pay options, establish medical savings accounts, use managed care plans, or join provider-sponsored plans.
Publications147 found, 100 shown here
- Implementation of risk adjustment for MedicareM J Ingber
Office of Strategic Planning, Health Care Financing Administration, Baltimore, MD 21244 1850, USA
Health Care Financ Rev 21:119-26. 2000....
- Reforming Medicare: impacts on federal spending and choice of health plansKenneth E Thorpe
Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
Health Aff (Millwood) . 2001..Our results highlight the fact that Medicare should expect modest savings from reforming the program. However, other goals of reform, such as establishing more efficient payments to plans, would be achieved...
- Rethinking adherenceJohn F Steiner
Institute for Health Research, Kaiser Permanente Colorado, Denver, CO 80237, USA
Ann Intern Med 157:580-5. 2012..To achieve the adherence goals set by CMS, front-line clinicians, interdisciplinary teams, organizational leaders, and policymakers will need to coordinate efforts in ways that exemplify the underlying principles of health care reform...
- Association between Medicare Advantage plan star ratings and enrollmentRachel O Reid
Centers for Medicare and Medicaid Services, Center for Medicare and Medicaid Innovation, Rapid Cycle Evaluation Group, Baltimore, MD 21244, USA
JAMA 309:267-74. 2013..The US Centers for Medicare & Medicaid Services publishes star ratings reflecting Medicare Advantage plan quality to inform enrollment decisions...
- Combining health plan performance indicators into simpler composite measuresAlan M Zaslavsky
Health Care Financ Rev 23:101-15. 2002..These summaries are substantively interpretable, internally consistent, and describe the majority of variation among units in the performance scores analyzed...
- The effect of benefits, premiums, and health risk on health plan choice in the Medicare programAdam Atherly
Department of Health Policy and Management, Emory University, Atlanta, GA 30322, USA
Health Serv Res 39:847-64. 2004..To estimate the effect of Medicare+Choice (M+C) plan premiums and benefits and individual beneficiary characteristics on the probability of enrollment in a Medicare+Choice plan...
- Beneficiary reported experience and voluntary disenrollment in Medicare managed careTerry R Lied
Health Care Financ Rev 25:55-66. 2003..The results demonstrate that voluntary disenrollment rates are strongly related to direct measures of patient experiences with care and are an important complement to other measures of health plan performance...
- Medicare showdownJohn K Iglehart
N Engl J Med 359:556-8. 2008
- Payment policy and competition in the Medicare+Choice programSteven D Pizer
Boston University, Department of Veterans Affairs, Abt Associates Inc, USA
Health Care Financ Rev 24:83-94. 2002....
- Principal inpatient diagnostic cost group model for Medicare risk adjustmentG C Pope
Health Economics Research, Inc, Waltham, MA 02452, USA
Health Care Financ Rev 21:93-118. 2000..In this article, the authors describe the risk-adjustment model HCFA is implementing in the year 2000, known as the Principal Inpatient Diagnostic Cost Group (PIPDCG) model...
- The welfare impact of Medicare HMOsRobert Town
University of Minnesota, USA
Rand J Econ 34:719-36. 2003..Consumer surplus increases in the number of plans in a county, and most of the increase in welfare is due to increased premium competition...
- Functional health outcomes as a measure of health care quality for Medicare beneficiariesA S Bierman
Center for Outcomes and Effectiveness Research, Agency for Healthcare Research and Quality, Rockville, MD 20852, USA
Health Serv Res 36:90-109. 2001..To interpret the HOS as a quality measure individual-and plan-level differences in functional status and illness burden, as well as methodologic issues in health status measurement, need to be recognized and addressed...
- The effect of health plan characteristics on Medicare+ Choice enrollmentBryan E Dowd
Division of Health Services Research, University of Minnesota, Minneapolis 55455, USA
Health Serv Res 38:113-35. 2003..To provide national estimates of the effect of out-of-pocket premiums and benefits on Medicare beneficiaries' choice among managed care health plans...
- Medicare health maintenance organization benefits packages and plan performance measuresDon Cox
BearingPoint, Inc, 1676 International Drive, McClean, VA 22102, USA
Health Care Financ Rev 24:133-44. 2002..Furthermore, disenrollment rates were found to be more sensitive to the availability of alternative M+C plans, either in general, or for specific benefits than to variations in benefit offerings...
- Health insurance knowledge among Medicare beneficiariesLauren A McCormack
RTI International, Research Triangle Park, NC 27709, USA
Health Serv Res 37:43-63. 2002..To assess the effect of new consumer information materials about the Medicare program on beneficiary knowledge of their health care coverage under the Medicare system...
- Medicare minus choice: the impact of HMO withdrawals on rural Medicare beneficiariesMichelle Casey
Rural Health Research Center, Division of Health Services Research and Policy, University of Minnesota, USA
Health Aff (Millwood) 21:192-9. 2002....
- An examination of factors in the withdrawal of managed care plans from the Medicare+Choice programMitchell P V Glavin
Schneider Institute for Health Policy, Brandeis University, Waltham, MA 02454, USA
Inquiry 39:341-54. 2002..The findings suggest HMO participation in Medicare+Choice will continue to fall unless major changes are made to the overall Medicare program and the method of paying HMOs...
- A tale of four cities: Medicare reform and competitive pricingB Dowd
Division of Health Services Research and Policy, University of Minnesota, USA
Health Aff (Millwood) 19:9-29. 2000..In the absence of political support, a demonstration of competitive pricing may be infeasible, and Congress could be forced to take the risky step of implementing broad Medicare reforms with very little information about their effects...
- Impact of Medicare managed care market withdrawal on beneficiariesBridget C Booske
University of Wisconsin Madison, 610 Walnut Street, Number 1167, Madison, WI 53726, USA
Health Care Financ Rev 24:95-115. 2002..Of particular concern were the impacts on those in vulnerable subgroups such as the disabled, less educated, and minorities...
- What does voluntary disenrollment from Medicare+Choice plans mean to beneficiaries?Lauren D Harris-Kojetin
RTI International, 1615 M St, NW, Suite 740, Washington, DC 20036, USA
Health Care Financ Rev 24:117-32. 2002..Medicare beneficiaries do not easily understand disenrollment. We also discuss challenges in presenting useful disenrollment information and policy implications for public reporting...
- Medigap premiums and Medicare HMO enrollmentCatherine G McLaughlin
Department of Health Management and Policy, School of Public Health, The University of Michigan, Ann Arbor 48109 2029, USA
Health Serv Res 37:1445-68. 2002..Similarly, our results imply that reforms to the Medicare HMO market would influence the demand for Medigap policies...
- Medicare+Choice: an interim report cardM Gold
Mathematica Policy Research, Washington, DC, USA
Health Aff (Millwood) 20:120-38. 2001....
- Disenrollment from Medicare HMOsK T Call
Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Box 729 Mayo, 420 Delaware Street SE, Minneapolis, MN 55455, USA
Am J Manag Care 7:37-51. 2001....
- National quality monitoring of Medicare health plans: the relationship between enrollees' reports and the quality of clinical careE C Schneider
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
Med Care 39:1313-25. 2001..The clinical quality of health plans varies. The associations between different measures of health plan quality are incompletely understood...
- More managed care for MedicareWilliam Atkinson
Healthplan 44:18-22. 2003
- Impact of an annual dollar limit or "cap" on prescription drug benefits for Medicare patientsChien Wen Tseng
Department of Family Practice and Community Health, University of Hawaii, and Pacific Health Research Institute, Honolulu, USA
JAMA 290:222-7. 2003..Annual dollar limits, or "caps," on drug benefits are common in Medicare managed care (Medicare + Choice) and have been part of several proposals for a national Medicare drug benefit...
- Comparison of cancer diagnosis and treatment in Medicare fee-for-service and managed care plansGerald F Riley
Office of Research, Development, and Information, Centers for Medicare and Medicaid Services, Baltimore, Maryland 21244, USA
Med Care 46:1108-15. 2008..To compare the Medicare managed care (MC) and fee-for-service (FFS) sectors on stage at diagnosis and treatment patterns for prostate, female breast, and colorectal cancers, and to examine patterns across MC plans...
- Law and the public's health. Medicare reformSara Rosenbaum
The Department of Health Policy, School of Public Health and Health Services, George Washington University, DC, USA
Public Health Rep 118:162-4. 2003
- Risk selection and benefits in the Medicare+Choice programRoger Feldman
University of Minnesota, Division of Health Services Research and Policy, Mayo Mail Code 729, 420 Delaware Street, SE, Minneapolis, MN 55455 0392, USA
Health Care Financ Rev 25:23-36. 2003..If M+C plans competed on the basis of benefits and premiums, as they would if they could give untaxed premium rebates, benefits that attract high risks would be underprovided...
- The impact of the Balanced Budget Act of 1997 on Medicare in the USA: the fallout continuesPatrick A Rivers
Graduate School of Health Administration and Policy, College of Business, Arizona State University, Tempe, Arizona, USA
Int J Health Care Qual Assur Inc Leadersh Health Serv 15:249-54. 2002..This article provides an update and examines the impacts of the Balanced Budget Act on health providers and medical education. The authors also discuss the implications of these impacts for further policy adjustment...
- Medicare+ChoiceChris Serb
Hosp Health Netw 77:42-4, 1. 2003..But enrollment has dropped and health plans, complaining of low reimbursement rates, have fled. What went wrong? Can it be fixed?..
- Medicare+Choice individual and group enrollment: 2001 and 2002Geoffrey R Hileman
Actuarial Research Corporation, 5513 Twin Knolls Road, Suite 213, Columbia, MD 21045, USA
Health Care Financ Rev 24:145-53. 2002
- Can managed care and competition control Medicare costs?Marsha Gold
Mathematica Policy Research, Washington, DC, USA
Health Aff (Millwood) . 2003....
- Trends in retiree health benefitsLauren A McCormack
RTI International, Research Triangle Park, North Carolina, USA
Health Aff (Millwood) 21:169-76. 2002..Indemnity enrollment remains strong among retirees, and employers are cautious about Medicare+Choice because of continuing plan withdrawals. Numerous indicators point to a further and accelerating decline in retiree coverage...
- Advantage cuts possible. Wyden wants regional data to rule on Medicare planJennifer Lubell
Mod Healthc 37:8-9. 2007
- A review of data on the health sector of the United States January 2002Ida Hellander
Physicians for a National Health Program, Chicago, IL 60602, USA
Int J Health Serv 32:579-99. 2002..Also provided is an update on Congressional activity on health care legislation, the role of health care industry money in politics, and some developments in health care systems elsewhere in the world...
- Influenza vaccination, hospitalizations, and costs among members of a Medicare managed care planJ W Davis
Hawaii Medical Service Association, Honolulu, HI 96814, USA
Med Care 39:1273-80. 2001..Associations were weaker for subjects age 80 and older. The results, consistent with recommendations for the use of influenza vaccine, suggest that people ages 65 to 79 should be heavily targeted for vaccination...
- Composite health plan quality scalesTodd Caldis
Centers for Medicare and Medicaid Services CMS, Baltimore, MD 21244 1850, USA
Health Care Financ Rev 28:95-107. 2007..90). External validity of the composite quality scale was checked by regressing the composite scale on Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey results for 1999...
- A randomized controlled open trial of population-based disease and case management in a Medicare Plus Choice health maintenance organizationDavid C Martin
Coventry Health Care, Inc, PA, USA
Prev Chronic Dis 1:A05. 2004....
- PACE and the Medicare+Choice risk-adjusted payment modelH Temkin-Greener
Community Coalition for Long-Term Care, Inc, 10 Gibbs St, Suite 410, Rochester, NY 14604, USA
Inquiry 38:60-72. 2001..The PIP-DCG payment model bases its risk adjustment on inpatient diagnoses and does not capture adequately the risk of caring for a population with functional impairments...
- Disenrollment information and Medicare plan choice: is more information better?Mark D Spranca
Abt Associates, Cambridge, MA 02420, USA
Health Care Financ Rev 28:47-59. 2007..It also reduced decision quality for less educated intermediaries. Designers and sponsors of consumer-oriented materials should recognize that more information is not always better...
- Towers Perrin 2002 Health Care Cost Survey: what consumers and employers are doing about the increasesRichard Ostuw
Towers Perrin, USA
Manag Care Q 10:16-25. 2002
- The Medicare Prescription Drug, Improvement and Modernization Act and the impact on care of people with chronic illness: benefit design and implementation issuesClaudia Schlosberg
Blank Rome LLP, Washington, DC 20037, USA
Care Manag J 5:113-21. 2004....
- Predictors of voluntary disenrollment from Medicare managed careJudy H Ng
National Committee for Quality Assurance, Washington, District of Columbia 20036, USA
Med Care 45:513-20. 2007..However, total selection bias depends not only on who enrolls, but also on who disenrolls. Few studies examine selectivity in disenrollment; it is unclear how those who leave plans differ from those who remain...
- Pursuing cost containment in a pluralistic payer environment: from the aftermath of Clinton's failure at health care reform to the Balanced Budget Act of 1997Rick Mayes
Department of Political Science, University of Richmond and Petris Centre on Health Care Markets and Consumer Welfare, University of California, Berkeley, CA, USA
Health Econ Policy Law 1:237-61. 2006....
- Medicare+Choice: what lies ahead?R Jeffrey Layne
Fulbright and Jaworski LLP, Washington, D C, USA
Healthc Financ Manage 56:70-4. 2002..Congressional leaders have proposed various legislative remedies to improve the program, including creation of an entirely new pricing structure for the program based on a competitive bidding process...
- Having it all: national benefit equity and local payment parity in MedicareBryan Dowd
Division of Health Services Research and Policy, University of Minnesota School of Public Health, USA
Health Aff (Millwood) 21:208-14. 2002....
- Pay raise. Increased HMO funding excites manyJeff Tieman
Mod Healthc 34:17. 2004
- Multiple prior years of health expenditures and Medicare health plan choiceMatthew L Maciejewski
Northwest HSR and D Center of Excellence, VA Puget Sound Health Care System, Department of Health Services, University of Washington, Seattle, WA, USA
Int J Health Care Finance Econ 4:247-61. 2004..The results indicate that beneficiaries use multiple years of expenditures in their choice of health plan and the effect of prior spending declined with time...
- Medicare+Choice: uncertain future for unstable programFrank Diamond
Manag Care 11:28-35. 2002
- Medicare+Choice: doubling or disappearing?Robert A Berenson
Academy for Health Services Research and Health Policy, USA
Health Aff (Millwood) . 2001....
- Medicare Advantage on hot seat. Congress presses officials on budgetary status quoMatthew DoBias
Mod Healthc 37:8-9. 2007
- Managed care does not appear to have a spillover effect on the quality of diabetes care for Medicare patientsSusan Edwards
Health Care Financing and Organization, USA
Find Brief 7:1-3. 2004
- Do the Medicare math, then make quick decisionJohn Carroll
Manag Care 13:18-20. 2004
- Further application of the care transitions intervention: results of a randomized controlled trial conducted in a fee-for-service settingCarla Parry
University of Colorado Denver, Aurora, Colorado 80045, USA
Home Health Care Serv Q 28:84-99. 2009..Coaching chronically ill older patients and their caregivers to ensure that their needs are met during care transitions may reduce the rate of subsequent rehospitalization in a Medicare fee-for-service population...
- Sociodemographic differences in use of preventive services by women enrolled in Medicare+Choice plansLeo S Morales
RAND Health, Santa Monica, CA 90407, USA
Prev Med 39:738-45. 2004..We examined the effect of sociodemographic factors on the receipt of mammography, colorectal cancer screening, and influenza vaccinations by women enrolled in two Medicare+Choice health plans...
- The Medicare world from both sides: a conversation with Tom Scully. Interview by Uwe E. ReinhardtTom Scully
United States Centers for Medicare and Medicaid Services, Baltimore, USA
Health Aff (Millwood) 22:167-74. 2003....
- Seniors with chronic health conditions and prescription drugs: benefits, wealth, and healthBarry G Saver
Department of Family Medicine, University of Washington, Seattle, WA 98195 4696, USA
Value Health 7:133-43. 2004....
- The Medicare Health Outcomes Survey program: overview, context, and near-term prospectsNathaniel Jones
Maryland Institute for Policy Analysis and Research MIPAR, University of Maryland, Baltimore County UMBC, 1000 Hilltop Circle, Baltimore, MD 21250, USA
Health Qual Life Outcomes 2:33. 2004..The new Medicare Prescription Drug, Improvement, and Modernization Act (2003) mandates the collection and use of data for outcomes measurement. Consequently, it is important to improve HOS to most effectively meet the mandate...
- Diabetes disease management in Medicare Advantage reduces hospitalizations and costsJames L Rosenzweig
Department of Medicine, Boston University, Boston, MA, USA
Am J Manag Care 16:e157-62. 2010..To evaluate the effectiveness of a telephonic diabetes disease management intervention in a Medicare Advantage population with comorbid diabetes and coronary artery disease (CAD)...
- Adjusted community rate reforms to promote HMO participation in Medicare+ChoiceW E Encinosa
University of Florida, USA
Health Care Financ Rev 21:19-29. 1999..The modifications include smoothing and bounding profit estimates and authorizing and encouraging expanded use of benefit stabilization funds...
- Innovations at Miami practice show promise for treating high-risk Medicare patientsCraig Tanio
ChenMed, Miami, Florida, USA
Health Aff (Millwood) 32:1078-82. 2013..Creating chronic disease centers focused on seniors with multiple chronic conditions is a promising delivery system innovation with major potential to improve the cost and quality of care...
- Geographic variation in cardiovascular procedure use among Medicare fee-for-service vs Medicare Advantage beneficiariesDaniel D Matlock
Division of General Internal Medicine, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA
JAMA 310:155-62. 2013..Little is known about how different financial incentives between Medicare Advantage and Medicare fee-for-service (FFS) reimbursement structures influence use of cardiovascular procedures...
- Creating a competitive PSO: a case studyJ T Calvaruso
Mount Carmel Health System, Columbus, OH, USA
Healthc Financ Manage 53:39-41. 1999..In the two years after instituting its provider-sponsored organization, Mount Carmel surpassed its original enrollment projections, decreased its patient management and utilization costs, and increased payments to its network members...
- Likelihood of hospital readmission after first discharge: Medicare Advantage vs. fee-for-service patientsBernard Friedman
Agency for Healthcare Research and Quality AHRQ, 540 Gaither Road, Rockville, MD 20850, USA
Inquiry 49:202-13. 2012..Analytical methods to adjust for self-selection into particular plans or plan types should be considered when possible...
- Analysis of a large cohort of health maintenance organization patients with congestive heart failurePatricia Gladowski
Quality Management Specialist, Highmark Blue Cross Blue Shield, Pittsburgh, PA 15222 3099, USA
Am J Med Qual 18:73-81. 2003..The use of a novel, cost-effective method for data collection resulted in the rapid acquisition of clinical data for analysis...
- How successful is Medicare Advantage?Joseph P Newhouse
Harvard Medical School Harvard School of Public Health Harvard University, John F Kennedy School of Government National Bureau of Economic Research
Milbank Q 92:351-94. 2014b>Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has generally been viewed as a policy disappointment...
- Risk adjustment for health plans disproportionately enrolling frail Medicare beneficiariesG F Riley
Office of Strategic Planning, Health Care Financing Administration, Baltimore 21244, MD, USA
Health Care Financ Rev 21:135-48. 2000..Further refinements are needed if diagnosis-based models are used to pay plans that disproportionately enroll frail beneficiaries...
- Who really wants price competition in Medicare managed care?L M Nichols
Urban Institute, Washington, D C, USA
Health Aff (Millwood) 19:30-43. 2000..A public report of this story may save future market-based Medicare reforms from a similar fate...
- Depression care and treatment in a chronically ill Medicare populationHsiang Huang
Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA 02139, USA
Gen Hosp Psychiatry 35:382-6. 2013..The purpose of this study is to examine depression care among chronically ill Medicare Advantage beneficiaries...
- Cost-lowering strategies used by medicare beneficiaries who exceed drug benefit caps and have a gap in drug coverageChien Wen Tseng
University of Hawaii Department of Family Practice and Community Health, Honolulu, and UCLA Department of Medicine, Los Angeles, Calif
JAMA 292:952-60. 2004....
- Favorable selection, risk adjustment, and the Medicare Advantage programMichael A Morrisey
Lister Hill Center for Health Policy, University of Alabama at Birmingham, Birmingham, AL 35294 0022, USA
Health Serv Res 48:1039-56. 2013..To examine the effects of changes in payment and risk adjustment on (1) the annual enrollment and switching behavior of Medicare Advantage (MA) beneficiaries, and (2) the relative costliness of MA enrollees and disenrollees...
- Medicare+Choice enrollees bring concerns to Capitol HillArnesa Howell
Healthplan 43:20-1. 2002
- Medicare+Choice risk adjustment: don't leave money on the tableJ K Gorman
Managed Care Compliance Solutions, Inc, Washington, D C, USA
Healthc Financ Manage 55:45-8. 2001..It is important to track members with chronic or terminal conditions that may qualify for higher payments and to appropriately code these conditions to optimize funds that may be owed to the organization...
- Economic burden and healthcare utilization associated with castration-resistant prostate cancer in a commercial and Medicare Advantage US patient populationB Alemayehu
Health Economics and Outcomes Research, AstraZeneca, 1800 Concord Pike, Wilmington, DE 19850, USA
J Med Econ 13:351-61. 2010..The objective of this study was to identify patients with CRPC from a medical claims database, and determine the prostate cancer-related economic burden and healthcare utilization of these patients...
- Expansion of dental benefits under the Medicare Advantage programRobert D Compton
Delta Dental Plan of Massachusetts, 465 Medford St, Boston, MA 02129, USA
J Dent Educ 69:1034-44. 2005....
- Early evidence on the quality of care provided by special needs plansMatthew L Maciejewski
Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC 27705, USA
Med Care 49:891-6. 2011..Medicare Advantage special needs plans (SNPs) have grown significantly over the past 7 years, but patient outcomes have only recently been publicly reported...
- Retiree health insurance: recent trends and tomorrow's prospectsLauren A McCormack
University of Wisconsin at Madison, USA
Health Care Financ Rev 23:17-34. 2002..The forces discouraging its growth--rising premium costs, a slower economy, judicial challenges, and an uncertain Medicare+Choice (M+C) program and policy agenda--far outweigh the forces likely to encourage expansion...
- Do Medicare Advantage enrollees tend to be admitted to hospitals with better or worse outcomes compared with fee-for-service enrollees?Bernard Friedman
Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA
Int J Health Care Finance Econ 10:171-85. 2010..With that proviso, the study justifies informing Medicare beneficiaries about the mortality and safety outcome measures for hospitals being used by a MA plan compared to hospitals used by FFS enrollees...
- Does Medicare managed care provide equal treatment for mental illness across races?Beth Virnig
Division of Health Services Research and Policy, University of Minnesota School of Public Health, Minneapolis 55455, USA
Arch Gen Psychiatry 61:201-5. 2004..We examined the quality of mental health care received by elderly enrollees in Medicare + Choice plans...
- Medicare Advantage reforms: comparing House and Senate billsBrian Biles
Department of Health Policy, Scool of Public Health and Health Services, George Washington University, USA
Issue Brief (Commonw Fund) 74:1-12. 2009..This issue brief compares the above and other provisions in the House and Senate bills, which have a common overall goal to improve the value that Medicare obtains for the dollars it spends..
- Regional associations between Medicare Advantage penetration and administrative claims-based measures of hospital outcomesVivek T Kulkarni
Yale University School of Medicine, New Haven, CT 06510, USA
Med Care 50:406-9. 2012..MA penetration varies greatly nationwide and seems to be associated with increased FFS population risk. Whether variation in MA penetration affects the performance on the Centers for Medicare and Medicaid Service measures is unknown...
- Medicare overpayments to private plans, 1985-2012: shifting seniors to private plans has already cost Medicare US$282.6 billionIda Hellander
The City University of New York, School of Public Health at Hunter College, New York, NY 10024, USA
Int J Health Serv 43:305-19. 2013..It is time to end Medicare's costly experiment with privatization. The U.S. needs to adopt a single-payer national health insurance program with effective methods for controlling costs...
- New risk-adjustment system was associated with reduced favorable selection in medicare advantageJ Michael McWilliams
Department of Health Care Policy at Harvard Medical School, Boston, Massachusetts, USA
Health Aff (Millwood) 31:2630-40. 2012..Similar risk-adjustment methods may help reduce incentives for plans competing in health insurance exchanges and accountable care organizations to select patients with favorable clinical risks...
- Guideline-recommended medications: variation across Medicare Advantage plans and associated mortalityAlfredo J Selim
VA New England Health Care System, 200 Springs Rd, Bldg 70, Bedford, MA 01730, USA
J Manag Care Pharm 19:132-8. 2013..To evaluate variation in the prescription of guideline-recommended medications across Medicare Advantage (MA) plans and to determine whether such variation is associated with increased mortality...
- Cost and management of males with closed fracturesS K Brenneman
OptumInsight, 12525 Technology Drive, Eden Prairie, MN 55344, USA
Osteoporos Int 24:825-33. 2013..The mean medical cost per fracture was high ($6,078-$30,900), and osteoporosis management post fracture was inadequate in the majority of men...
- Pharmacist-provided telephonic medication therapy management in an MAPD planMelea A Ward
Humana Inc, Competitive Health Analytics, 321 W Main St, WFP6W, Louisville, KY 40202, USA
Am J Manag Care 17:e399-409. 2011....
- Cost trends among commercially insured and Medicare Advantage-insured patients with chronic obstructive pulmonary disease: 2006 through 2009Anand A Dalal
US Health Outcomes, GlaxoSmithKline, Research Triangle Park, Durham, NC 27709, USA
Int J Chron Obstruct Pulmon Dis 6:533-42. 2011....
- Receipt of high risk medications among elderly enrollees in Medicare Advantage plansDanya M Qato
Department of Health Services, Policy and Practice, Alpert Medical School of Brown University, 121 S Main St, Box G S121, Providence, RI 02912, USA
J Gen Intern Med 28:546-53. 2013..Since 2005, the Centers for Medicare and Medicaid Services (CMS) has required all Medicare Advantage (MA) plans to report prescribing rates of high risk medications (HRM)...
- How health reform legislation will affect Medicare beneficiariesStuart Guterman
Commonwealth Fund, USA
Issue Brief (Commonw Fund) 81:1-10. 2010....
- Medicare Advantage under fire. House and Senate have overpayments in their sightsMatthew DoBias
Mod Healthc 37:8-9. 2007
- The value of coverage in the medicare advantage insurance marketAbe Dunn
Bureau of Economic Analysis, U S Department of Commerce, 1441 L Street NW, Washington, DC 20230, United States
J Health Econ 29:839-55. 2010..The results of the demand model show that OOPC have a significant effect on consumer surplus and that not instrumenting for OOPC results in a significant underestimate of the value of coverage...
- Boost for Medicare Advantage. Congress questions why plans getting payment raiseMatthew DoBias
Mod Healthc 37:8-9. 2007
- Health care provider evaluation of a substitutive model of hospital at homeJill A Marsteller
Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
Med Care 47:979-85. 2009..To evaluate Hospital at Home (HaH), a substitute for inpatient care, from the perspectives of participating providers...
- The Medicare disadvantageKen Ortolon
Tex Med 103:41-2. 2007
- Search costs and Medicare plan choiceIan M McCarthy
FTI Consulting, Dallas, TX, USA
Health Econ 19:1142-65. 2010..Our results suggest that, conditional on being uninformed, older, higher income beneficiaries with lower self-reported health status are more likely to utilize easier access to information...
- The association of adherence to osteoporosis therapies with fracture, all-cause medical costs, and all-cause hospitalizations: a retrospective claims analysis of female health plan enrollees with osteoporosisRachel Halpern
Health Economics and Outcomes Research, i3 Innovus, 12125 Technology Dr, MN002 0258, Eden Prairie, MN 55344, USA
J Manag Care Pharm 17:25-39. 2011..Poor adherence to osteoporosis medications is associated with higher general burden of illness compared with optimal adherence...
- No advantage. Little quality progress at managed-care plans: reportJennifer Lubell
Mod Healthc 37:8-9. 2007
- How do the experiences of Medicare beneficiary subgroups differ between managed care and original Medicare?Marc N Elliott
RAND Corporation, Santa Monica, CA, USA
Health Serv Res 46:1039-58. 2011..To examine whether disparities in health care experiences of Medicare beneficiaries differ between managed care (Medicare Advantage [MA]) and traditional fee-for-service (FFS) Medicare...
- Health of Medicare Advantage plan enrollees at 1 year after Hurricane KatrinaLynda C Burton
Johns Hopkins University Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, USA
Am J Manag Care 15:13-22. 2009....
- The potential impact of the World Trade Organization's general agreement on trade in services on health system reform and regulation in the United StatesNicholas Skala
Northwestern University School of Law, Chicago, IL 60611, USA
Int J Health Serv 39:363-87. 2009....
- The Role of Private Plans in MedicareJOSEPH PAUL NEWHOUSE; Fiscal Year: 2013..Program Project is to undertake a fundamental examination of the theoretical and empirical underpinnings of Medicare Part C, or Medicare Advantage (MA) from a framework grounded in economic theory...
- Coverage, Organization of Care, and Colorectal ScreeningEric Schneider; Fiscal Year: 2004..Results of this study can guide the enactment of health policies that will increase rates of colorectal cancer screening and thereby reduce the incidence of colorectal cancer and its associated morbidity and mortality. ..
- Reimbursement Policy and Cancer ChemotherapyJoseph Newhouse; Fiscal Year: 2009..Understanding its impact on chemotherapy treatment patterns has important implications not only for Medicare spending but also for the welfare of beneficiaries with cancer. ..
- MD Group Characteristics and Quality of Care for CHDBruce Landon; Fiscal Year: 2003..abstract_text> ..
- Financial Incentives and Variations in the Care of Medicare BeneficiariesBruce E Landon; Fiscal Year: 2010..Because patients will be clustered within physicians and physicians clustered within markets, we will use hierarchical analytic methods. ..
- Scalable PArtnering Network for CER: Across Lifespan, Conditions, and SettingsJohn F Steiner; Fiscal Year: 2010..Findings will inform evidence-based health care and improve the national allocation of health care resources. ..
- Development of an Instrument to Measure Health LiteracyLauren McCormack; Fiscal Year: 2009....
- Enhancing the Safety of Warfarin in the Nursing HomeJerry Gurwitz; Fiscal Year: 2008..abstract_text> ..
- An Epidemiologic Study of Lymph Node Evaluation in Colorectal Cancer PatientsBeth Virnig; Fiscal Year: 2007..Most CRC patient in the U.S. do not have an adequate node evaluation. This research will identify factors that affect the adequacy of lymph node staging in CRC so that improvements can be made. [unreadable] [unreadable]..
- Mental Health Spending and Quality of CareThomas G McGuire; Fiscal Year: 2010..We expand methods of the science of variations and apply them to mental health care using data from the Medicaid program. ..
- Health Information Technology in the Nursing HomeJerry Gurwitz; Fiscal Year: 2006..abstract_text> ..
- Spatial Impact Factors and Mammography ScreeningLee Mobley; Fiscal Year: 2006..This work will demonstrate the feasibility of conducting a broader study encompassing more than twice as many counties of the United States (with additions covered by the expanded SEER database). ..
- HMO Research Network ConferenceJerry Gurwitz; Fiscal Year: 2006..unreadable] [unreadable] [unreadable] [unreadable]..
- SELECTION BIAS BY MEDICARE BENEFICIARIES WITH DIABETESMatthew Maciejewski; Fiscal Year: 2002..Analyses will be conducted on a cohort of beneficiaries with diabetes in thc fee-for-service sector in 1992-1993, so results are not generalizable to people with diabetes who enrolled in Medicare HMOs prior to 1994...
- REDUCING ADVERSE DRUG EVENTS IN THE NURSING HOMEJerry Gurwitz; Fiscal Year: 2002..abstract_text> ..
- MH AND ADVERSE SELECTION IN MANAGED CAREThomas McGuire; Fiscal Year: 2001..Understanding how adverse selection works in managed care and what can be done about it should be a very high priority for research. ..
- Industry-Sponsored Research Contracts:An Empirical StudyMichelle Mello; Fiscal Year: 2002..The data will be analyzed descriptively and with chi-squared tests and regression analysis. ..
- Effects of Health Plan Report Cards on Quality of CareMARY BUNDORF; Fiscal Year: 2004..This information is essential for both large purchasers, such as the Medicare program and employers, and policy makers to determine the appropriate role of these types of interventions in improving quality of care. ..
- The Health Insurance Dynamics of Older AmericansMARY BUNDORF; Fiscal Year: 2004..abstract_text> ..
- Medicare + Choice a nd Minority ElderlyRobert Morgan; Fiscal Year: 2004..abstract_text> ..
- Industry-Sponsored Research Contracts:..Phase IIMichelle Mello; Fiscal Year: 2004..abstract_text> ..
- Economics of Racial & Ethnic Disparities in MH ServicesThomas McGuire; Fiscal Year: 2005..Test for evidence that patient reaction to provider discrimination leads to lower compliance rates and worse outcomes for these minorities. ..
- NETWORK EFFECTS IN MENTAL HEALTH MANAGED CAREThomas McGuire; Fiscal Year: 2002..4) Test the behavior of the managed care plans against the predictions of the optimal network theory. ..