The Implementation of the Medicare+Choice Program
The Implementation of the Medicare+Choice Program

Author: Craig Schneider

Publisher: LAP Lambert Academic Publishing

Published: 2009-09

Total Pages: 364

ISBN-13: 9783838309774

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The Balanced Budget Act of 1997 made the most substantial changes to the Medicare program since its inception in 1965. One of the most significant changes was the enactment of the Medicare+Choice program, which would create opportunities for four new types of private plan options for Medicare beneficiaries, along with the existing Medicare HMO option and the traditional fee-for-service option. This experiment was generally not successful, and this study was designed to explore the reasons that the program did not succeed. The methodology involves interviews with subject matter experts representing Congressional staff, Medicare officials, and insurance industry employees; exploration of analytical implementation models; and an original methodology termed assertion analysis. The research question that the study primarily addresses is what factor is most responsible for the problems of Medicare+Choice: the Congressional design of the program, the performance of CMS in implementing the program, or the dramatic changes in the healthcare system that occurred during the 1995-99 period.

Developing an Information Infrastructure for the Medicare+Choice Program
Developing an Information Infrastructure for the Medicare+Choice Program

Author: Committee on Choice and Managed Care: Furthering the Knowledge Base to Ensure Public Accountability and Information for Informed Purchasing by and on Behalf of Medicare Beneficiaries

Publisher: National Academies Press

Published: 1999-02-23

Total Pages: 75

ISBN-13: 0309592941

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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.

Medicare and Choice
Medicare and Choice

Author: William J. Scanlon

Publisher: DIANE Publishing

Published: 2001-04

Total Pages: 70

ISBN-13: 9780756708931

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Following the implementation of Medicare+Choice, many health care plans terminated their contracts & fully withdrew from the program or partially withdrew by reducing the geographic areas they served, & more have announced that they will withdraw for the 2001 contract year. This report (1) determines the geographic distribution & the distribution among plans of enrollees affected by the recent plan withdrawals, (2) identifies the factors associated with plans that terminated or reduced their participation in the program, & (3) examines the likely role of payment rates in affecting plans' decisions. Analyzes enrollment & plan participation data. Tables.