Medicare HMOs: Making Them Work for the Chronically Ill
Health Administration Press, 1999 - Medical - 238 pages
The lure of reduced costs & improved health outcomes has spurred the Medicare managed care movement. But will these desired outcomes be achieved? This book explores the role of HMOs in Medicare & the implications it has on the health of the chronically ill. Includes suggested strategies for oversight & regulation of Medicare HMOs.
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Introduction and Overview
The Problem of Selection in Medicare RiskContract HMOs
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AAPCC additional adverse selection areas average benefit choices benefit packages brokers capitation capitation rates Chapter chronically ill ciaries compared consumer coordinated open enrollment copayments costs deductible disabled disenrollment rates durable medical equipment eficiaries elderly employers end-of-life example expenditures favorable selection fee-for-service fee-for-service plans HCFA HCFA's Health Care Financing health insurance health status health-based payment healthcare HMO enrollees hospital implementation incentives individuals Kronick Langwell legislation limited managed care plans Mark Merlis Medi Medicaid medical savings accounts Medicare beneficiaries Medicare HMOs Medicare managed Medicare program Medicare Risk Medicare+Choice plans Medigap plans Medigap policies ment offer open enrollment period options patients payment system percent physicians PIPDCG premium prescription drugs price competition problems reduce requirements risk adjustment risk selection selection bias sicker standardized substantial supplemental benefits supplemental coverage survey switch tion traditional Medicare USGAO