Federal Oversight of Medicare HMOs: Assuring Beneficiary Protection : Hearing Before the Special Committee on Aging, United States Senate, One Hundred Fourth Congress, First Session, Washington, DC, August 3, 1995, Volume 4
U.S. Government Printing Office, 1995 - Medical - 182 pages
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EXECUTIVE SUMMARY i
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access problems accreditation appeal rights believe California Chairman CHCR CHCR's complaints Confidence Interval contracting medical groups cost coverage Dallek denial denied Disabled/ESRD disenrollment rates employers enrollees and disenrollees enrollment ensure ESRD Federal fee-for-service ficiaries going guidelines HCFA HCFA's Health Care Financing Health Maintenance Organizations health plans health status HEDIS HICAP HMO experience HMO's home health hospital issues Jaggar managed care plans managed care programs Medicaid Medicare beneficiaries Medicare covered services Medicare enrollees Medicare HMOs Medicare program Medicare risk HMOs monitoring months NCQA nursing home out-of-plan oversight patient payment percent performance measures physical therapy primary care physician primary HMO doctors Prior HMO exp private sector Proportion of beneficiaries quality assurance reasons for leaving received referrals responses retroactive disenrollment risk contracts sampled HMO satisfaction scheduled appointments Senator Pryor service access skilled nursing specialists specialty staff standards surgery survey Thank Vladeck waiting