Improving the Medicare Market

Improving the Medicare Market PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175364
Category : Medical
Languages : en
Pages : 384

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Book Description
Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.

Improving the Medicare Market

Improving the Medicare Market PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175364
Category : Medical
Languages : en
Pages : 384

Get Book

Book Description
Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.

Improving the Medicare Market

Improving the Medicare Market PDF Author:
Publisher:
ISBN: 9780309055352
Category : Managed care plans (Medical care)
Languages : en
Pages : 0

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Book Description


The Medicare Handbook

The Medicare Handbook PDF Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 60

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Book Description


Modernizing Medicare

Modernizing Medicare PDF Author: Robert Emmet Moffit
Publisher: JHU Press
ISBN: 1421446022
Category : Law
Languages : en
Pages : 228

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Book Description
Top policy experts offer Medicare reform solutions for the millions of seniors whose health care depends on America's fastest growing federal entitlement. In Modernizing Medicare, editors Robert Emmet Moffit and Marie Fishpaw bring together a rare combination of leading scholars and policy practitioners to outline a vision for Medicare reform and provide solutions for the millions of seniors whose health care depends on it. Contributors include a former Medicare trustee, a former Medicare administrator, and a former director of the Congressional Budget Office. Detailing Medicare's biggest problems, this team of top policy experts offer solutions based on personal freedom of choice, transparency of price and performance, and market competition among health plans and providers that will secure patients more affordable, more accountable, and higher quality medical care. They also address Medicare's reform needs and analyze the promising performance of the Medicare Advantage program. The authors outline Medicare's major financial problems and the best solutions for Medicare patients and taxpayers alike. While Medicare's accelerating spending is generating higher deficits and debt, standard cost-control strategies—such as payment reductions and price controls—jeopardize patients' access to high-quality care. Contributors: Joseph R. Antos, PhD; Doug Badger; Charles P. Blahous, PhD; Walton F. Francis; John C. Goodman, PhD; Edmund F. Haislmaier; Douglas Holtz-Eakin, PhD; Brian J. Miller, MD, MBA, MPH; Robert Emmet Moffit, PhD; Mark V. Pauly, PhD; Christopher M. Pope, PhD; Gail R. Wilensky, PhD.

Developing an Information Infrastructure for the Medicare+Choice Program

Developing an Information Infrastructure for the Medicare+Choice Program PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309063884
Category : Medical
Languages : en
Pages : 75

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Book Description
On March 4 and 5, 1998, the Institute of Medicine (IOM) Committee on Choice and Managed Care held a 2-day workshop entitled Developing the Information Infrastructure for Medicare Beneficiaries. This workshop was a follow-up to the IOM report entitled Improving the Medicare Market: Adding Choice and Protections. The workshop focused on the Medicare provisions in the Balanced Budget Act of 1997, which mandate that the Health Care Financing Administration (HCFA) develop a "nationally coordinated education and publicity campaign" in 1998 and move Medicare beneficiaries to an open-season enrollment process by the year 2002.

The Affordable Care Act

The Affordable Care Act PDF Author: Tamara Thompson
Publisher: Greenhaven Publishing LLC
ISBN: 0737776196
Category : Young Adult Nonfiction
Languages : en
Pages : 130

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Book Description
The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

Improving the Quality of Long-Term Care

Improving the Quality of Long-Term Care PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309132746
Category : Medical
Languages : en
Pages : 344

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Book Description
Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.

Geographic Adjustment in Medicare Payment

Geographic Adjustment in Medicare Payment PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309257980
Category : Medical
Languages : en
Pages : 262

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Book Description
Medicare, the world's single largest health insurance program, covers more than 47 million Americans. Although it is a national program, it adjusts payments to hospitals and health care practitioners according to the geographic location in which they provide service, acknowledging that the cost of doing business varies around the country. Under the adjustment systems, payments in high-cost areas are increased relative to the national average, and payments in low-cost areas are reduced. In July 2010, the Department of Health and Human Services, which oversees Medicare, commissioned the IOM to conduct a two-part study to recommend corrections of inaccuracies and inequities in geographic adjustments to Medicare payments. The first report examined the data sources and methods used to adjust payments, and recommended a number of changes. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency applies the first report's recommendations in order to determine their potential effect on Medicare payments to hospitals and clinical practitioners. This report also offers recommendations to improve access to efficient and appropriate levels of care. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency expresses the importance of ensuring the availability of a sufficient health care workforce to serve all beneficiaries, regardless of where they live.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination PDF Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 030946921X
Category : Medical
Languages : en
Pages : 161

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Book Description
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Understanding Medicare Managed Care

Understanding Medicare Managed Care PDF Author: Louis F. Rossiter
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 408

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Book Description
A reference for health-care executives and physicians as well as managers, administrators, and staff of Medicare managed-care plans, providing a structure for plotting a long-term plan to compete in this market. In addition to describing the economics of the current system, including trends and key players, the book covers strategic planning and marketing, including issues such as pricing and the capitation dollar, benefit design, and techniques of quality and cost control. Finally, the work speculates about future changes in the system and the health-care marketplace and their implications for health plan participation. The author is deputy secretary for Health and Human Resources, Commonwealth of Virginia, and previously was a member of the health economics faculty of Virginia Commonwealth U. Annotation copyrighted by Book News, Inc., Portland, OR