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Author: Katherine Baicker
Publisher:
ISBN:
Category : Economics
Languages : en
Pages : 0
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Book Description
More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage program on the traditional Medicare program and other patients, taking advantage of changes in Medicare Advantage payment policy to isolate exogenous increases in Medicare Advantage enrollment and trace out the effects of greater managed care penetration on hospital utilization and spending throughout the health care system. We find that when more seniors enroll in Medicare managed care, hospital costs decline for all seniors and for commercially insured younger populations. Greater managed care penetration is not associated with fewer hospitalizations, but is associated with lower costs and shorter stays per hospitalization. These spillovers are substantial - offsetting more than 10% of increased payments to Medicare Advantage plans.
Author: Katherine Baicker
Publisher:
ISBN:
Category : Economics
Languages : en
Pages : 0
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Book Description
More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage program on the traditional Medicare program and other patients, taking advantage of changes in Medicare Advantage payment policy to isolate exogenous increases in Medicare Advantage enrollment and trace out the effects of greater managed care penetration on hospital utilization and spending throughout the health care system. We find that when more seniors enroll in Medicare managed care, hospital costs decline for all seniors and for commercially insured younger populations. Greater managed care penetration is not associated with fewer hospitalizations, but is associated with lower costs and shorter stays per hospitalization. These spillovers are substantial - offsetting more than 10% of increased payments to Medicare Advantage plans.
Author: Qianwei Shen
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 92
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Book Description
The percentage of Medicare beneficiaries enrolled in Medicare Advantage (MA) plans increased from 12 percent in 2003 to 28 percent in 2013 out of the about 50 million Medicare enrollees. Although Medicare beneficiaries are increasingly choosing MA plans, little is known about whether and how the market penetration of these plans affect the quality of hospital care provided to Medicare beneficiaries. This issue is extremely important to policy makers when they try to evaluate the importance and effectiveness of current Medicare policy, like Obama Care. This paper is designed to examine the spillover effect on the quality of hospital care under traditional Medicare responds to the local market penetration of MA plans, such as MA health maintenance organizations (HMOs), MA preferred provider organizations (PPOs), and MA private fee-for-service (PFFS) plans. Using nationally representative data from the 2006 to 2009 Medicare Current Beneficiary Survey and enrollment data from CMS, this study shows that higher Medicare Advantage plan penetrations are associated with lower readmission. Thus, I conclude that the expansion of Medicare Advantage plans has a positive spillover effect on quality of care received by individuals enrolled in traditional Medicare plans.
Author: Laurence C. Baker
Publisher:
ISBN:
Category : Health maintenance organizations
Languages : en
Pages : 56
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Book Description
Increases in the activity of managed care organizations are likely to have a number of implications for the structure and functioning of the US health care market. One possibility is that increases in managed care activity may have 'spillover effects,' influencing the performance of the entire health care delivery system, so that care for both managed care and non-managed-care patients is affected. Some discussions of Medicare reform have incorporated spillover effects as a way that increasing Medicare HMO enrollment could contribute to savings for Medicare. This paper investigates the relationship between HMO market share and expenditures for the care of beneficiaries enrolled in traditional fee-for-service Medicare. We find that increases in system-wide HMO market share (including Medicare and non-Medicare enrollment) are associated with declines in both Part A and Part B fee-for-service expenditures. The fact that managed care can influence expenditures for this population suggests that managed care activity can have broad effects on the entire health care market. Increases in Medicare HMO market share are linked with increases in Part A expenditures and with small decreases in Part B. This suggests that any spillovers directly associated with Medicare HMO enrollment are small. For general health care policy discussions, these results suggest assessment of new policies should account not only for the effects of managed care on enrollees, but also for its system-wide effects. For Medicare policy discussions, these findings imply previous results that showed the existence of large spillover effects associated with increases in Medicare HMO market share, but did not account for system-wide managed care activity and relied on older data, overstated the magnitude of actual Medicare spillovers.
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
Author: Robert Tyler Braun
Publisher:
ISBN:
Category :
Languages : en
Pages : 82
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Objective: To examine spillovers from a federal policy, managed care market, and community perspective. Data Sources/Study Setting: We studied spillovers from a federal policy and managed care market perspective using the Health Care Utilization Project's (HCUP) State Inpatient Database (SID). American Hospital Association (AHA) data, Interstudy Commercial Managed Care, and Area Health Resource File (AHRF). Medicare Advantage county-level payment schedules originate from CM. S. We examined community uninsurance spillovers using 2011-2015 Medical Expenditure Panel Survey (MEPS), the Area Health Resource File (AHRF), and the Small Area Health Insurance Estimator (SAHIE). Study Design: Ordinary Least Squares (OLS) and difference-in-difference regression analyses were used to examine a federal policy spillover on hospital readmissions. We used OLS and instrumental variable (IV) estimation to examined Medicare Advantage (MA) spillovers on Medicare fee-for-service (FFS) hospital readmissions. We used logistic regression to examine community uninsurance spillovers on the privately insured. Principal Findings: After the HRRP, Medicare FFS saw a decrease in 30-day preventable condition- and all-cause readmissions. Medicare Advantage saw a positive spillover after the HRRP. MA market penetration has no effect on Medicare FFS hospital readmissions. High community uninsurance rates are associated with less access to behavioral health related outpatient/office-based and prescription utilization. Conclusions: HRRP had a positive spillover on MA hospital all-cause readmissions. MA market penetration has no effect on Medicare FFS readmissions. High levels of community uninsurance are associated with poorer access to outpatient/office-based and prescription behavioral related services.
Author: Mark V. Pauly
Publisher: Elsevier
ISBN: 0444535926
Category : Business & Economics
Languages : en
Pages : 1149
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Book Description
"As a relatively new subdiscipline of economics, health economics has made many contributions to areas of the main discipline, such as insurance economics. This volume provides a survey of the burgeoning literature on the subject of health economics." {source : site de l'éditeur].
Author: United States. Congress. Senate. Special Committee on Aging
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 140
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Author: United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 100
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Author: Medicare Payment Advisory Commission (U.S.)
Publisher:
ISBN:
Category : Hospitals
Languages : en
Pages : 184
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Author: United States. General Accounting Office
Publisher:
ISBN:
Category : Administrative remedies
Languages : en
Pages : 44
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