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Author: James C. Cosgrove
Publisher: DIANE Publishing
ISBN: 1437934439
Category : Health & Fitness
Languages : en
Pages : 44
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Book Description
Nearly 11 million Medicare beneficiaries are enrolled in Medicare Advantage (MA), Medicare's private health insur. option. Benefits vary by MA plan and may include coverage for services not avail. in traditional Medicare. To ensure MA plan benefit package designs do not discriminate against beneficiaries in poor health with high expected health care costs, the Centers for Medicare & Medicaid Serv. (CMS) reviews and approves all benefit packages yearly. This report examined: (1) MA plan benefit packages by average health status of plans' enrolled beneficiaries; (2) dist. and characteristics of MA plans by average beneficiary health status; and (3) CMS's process for ensuring that benefit packages do not discriminate with respect to health status. Charts and tables.
Author: James C. Cosgrove
Publisher: DIANE Publishing
ISBN: 1437934439
Category : Health & Fitness
Languages : en
Pages : 44
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Book Description
Nearly 11 million Medicare beneficiaries are enrolled in Medicare Advantage (MA), Medicare's private health insur. option. Benefits vary by MA plan and may include coverage for services not avail. in traditional Medicare. To ensure MA plan benefit package designs do not discriminate against beneficiaries in poor health with high expected health care costs, the Centers for Medicare & Medicaid Serv. (CMS) reviews and approves all benefit packages yearly. This report examined: (1) MA plan benefit packages by average health status of plans' enrolled beneficiaries; (2) dist. and characteristics of MA plans by average beneficiary health status; and (3) CMS's process for ensuring that benefit packages do not discriminate with respect to health status. Charts and tables.
Author: U.s. Government Accountability Office
Publisher:
ISBN: 9781974624157
Category :
Languages : en
Pages : 44
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Book Description
"Nearly 11 million Medicare beneficiaries are enrolled in Medicare Advantage (MA), Medicare's private health insurance option. Benefits vary by MA plan and may include coverage for services not available in traditional Medicare. To ensure MA plan benefit package designs do not discriminate against beneficiaries in poor health with high expected health care costs, the Centers for Medicare & Medicaid Services (CMS) reviews and approves all benefit packages yearly.GAO examined (1) MA plan benefit packages by average health status of plans' enrolled beneficiaries, (2) distribution and characteristics of MA plans by average beneficiary health status, and (3) CMS's process for ensuring that benefit packages do not discriminate with respect to health status. Using 2008 data on beneficiaries' expected health care costs, the most recent data available, GAO sorted 2,899 plans enrolling 7.5 million beneficiaries into three groups: good health (below-average expected costs), average health, and poor health (above-average expected costs). GAO then analyzed MA plan benefit packages by health group and reviewed CMS documentation and interviewed agency officials on CMS's benefit package review process. GAO did not determine whether plans structured benefit packages..."
Author: United States Government Accountability Office
Publisher: Createspace Independent Publishing Platform
ISBN: 9781983725005
Category :
Languages : en
Pages : 44
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Book Description
Medicare Advantage: Relationship between Benefit Package Designs and Plans' Average Beneficiary Health Status
Author: United States. Government Accountability Office
Publisher:
ISBN:
Category : Medicare
Languages : en
Pages : 38
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Book Description
Author: James C. Cosgrove
Publisher: DIANE Publishing
ISBN: 1437901557
Category : Medical
Languages : en
Pages : 56
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Book Description
In 2006, the fed. govt. spent $59 billion on Medicare Advantage (MA) plans, an alternative to the original Medicare fee-for-service (FFS) program. Although health plans were originally envisioned as a source of Medicare savings, such plans have generally increased program spending. Payments to MA plans have been estimated to be 12% greater than what Medicare would have spent in 2006 had MA beneficiaries been enrolled in Medicare FFS. This report examines for 2007: (1) MA plan¿s projected rebate allocations; (2) additional benefits MA plans commonly covered & their costs; (3) MA plans¿ projected cost sharing; & (4) MA plans¿ allocation of projected revenues and expenses. Tables and graphs.
Author: James Cosgrove
Publisher: DIANE Publishing
ISBN: 1437901719
Category : Medical
Languages : en
Pages : 16
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Book Description
Although private health plans were originally envisioned in the 1980s as a potential source of Medicare savings, such plans have generally increased program spending. In 2006, Medicare paid $59 billion to Medicare Advantage (MA) plans -- an estimated $7.1 billion more than Medicare would have spent if MA beneficiaries had received care in Medicare fee-for-service (FFS). MA plans receive a per member per month payment to provide services covered under Medicare FFS. For this testimony, the author examined MA plans¿: (1) projected allocation of rebates; (2) projected cost sharing; and (3) projected revenues and expenses. Charts and tables.
Author: Lyle Nelson
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 68
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Book Description
And introduction -- Traditional Medicare and private health plans -- Issues in designing a premium support system for Medicare -- Health care systems that are similar to premium support -- Potential effects of selected approaches to premium support -- Technical aspects of the analysis -- Supplementary tables.
Author: United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health
Publisher:
ISBN:
Category : Medical fees
Languages : en
Pages : 96
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Book Description
Author: U.s. Government Accountability Office
Publisher: Createspace Independent Publishing Platform
ISBN: 9781974624126
Category :
Languages : en
Pages : 40
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Book Description
"The Centers for Medicare & Medicaid Services (CMS) pays plans in Medicare Advantage (MA)-the private plan alternative to Medicare fee-for-service (FFS)-an amount per beneficiary that is adjusted to reflect beneficiary health status. This adjustment, called risk adjustment, helps ensure that health plans have the same financial incentive to enroll and care for beneficiaries regardless of their health status. In 2010, CMS announced plans to revise the major medical conditions included in its principal risk-adjustment model-the community model-and add a model for new enrollees in chronic condition special needs plans (C-SNP), which target beneficiaries with certain severe or disabling chronic conditions. CMS began using the C-SNP new enrollee model in 2011, in place of the general new enrollee model, to adjust MA payments for new Medicare beneficiaries who enroll in a C-SNP. GAO was asked to examine the accuracy of these models for high-risk beneficiaries. Using data for a nationally representative sample of 2007 FFS beneficiaries, GAO computed the amount that expenditure estimates were above or below actual expenditures for 2007, the most recent data available at the time. GAO compared the accuracy of the current and revised community models for three high-risk groups: beneficiaries with multiple chronic conditions, with low income, and with dementia. GAO compared the accuracy of the general and C-SNP new enrollee models for new enrollees eligible to enroll in a C-SNP. What GAO Found The effect of CMS's revised community model on payment accuracy varied for the high-risk groups studied. Specifically, compared with the current community model, the revised community model slightly reduced the accuracy of MA payment adjustments for beneficiaries with multiple chronic conditions by $164, or about 1 percent of average actual expenditures. For beneficiaries with low income, the accuracy of the revised and the current community models was similar: estimates differed by $5, o..."
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 120
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Book Description
