Medicare Managed Care: Observations about Medicare Cost Plans
DIANE Publishing, 2010 - 35 pages
Medicare cost plans ¿ managed care plans paid based on the reasonable costs of delivering Medicare-covered services ¿ enroll a small number of beneficiaries compared to Medicare Advantage (MA), Medicare¿s managed care program in which the plans accept financial risk if their costs exceed fixed payments received for each enrolled beneficiary. This report: (1) determined the MA options available to beneficiaries in cost plans; (2) described key differences for beneficiaries between cost plans, MA plans, and Medicare Fee-For-Service; (3) determined the extent to which organizations offering cost plans also offer MA plans; and (4) described concerns cost plans have about converting to MA plans. Charts and tables.
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12 cost plans 18 organizations analysis of CMS beneficiaries enrolled beneficiaries in cost Beneficiaries Reporting Poor CCPs CMS data competing MA plans competitors Plans contract level Cost Contractors Alliance cost plan benefit cost plan enrollment Cost plan’s out-of-pocket cost plan’s service counties drug coverage enrolled in cost estimated out-of-pocket costs excellent health existing cost plans financial risk GAO analysis Government Accountability Office Health Maintenance Organization HMOs managed care plans Medicaid Medical Savings Account Medicare Advantage Medicare Cost Contractors Medicare cost plans Medicare FFS Medicare managed Medicare Prescription Drug MIPPA Number of Cost offered cost plans Open Nonprofit open to enrollment operated options organization’s organizations offering cost organizations that offered osteoporosis PFFS plans plan benefit package plan offered plan summary score plan’s out-of-pocket costs plan’s service area Plans and Medicare plans with drug plans without drug Preferred Provider Organization quality dimensions quality scores Regional PPOs reporting poor health special needs plans