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Improving The Medicare Market
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Book Synopsis Improving the Medicare Market by : Institute of Medicine
Download or read book Improving the Medicare Market written by Institute of Medicine and published by National Academies Press. This book was released on 1996-12-01 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.
Download or read book The Medicare Handbook written by and published by . This book was released on with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Modernizing Medicare by : Robert Emmet Moffit
Download or read book Modernizing Medicare written by Robert Emmet Moffit and published by JHU Press. This book was released on 2023-04-04 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: Top policy experts offer Medicare reform solutions for the millions of seniors whose health care depends on America's fastest growing federal entitlement. In Modernizing Medicare, editors Robert Emmet Moffit and Marie Fishpaw bring together a rare combination of leading scholars and policy practitioners to outline a vision for Medicare reform and provide solutions for the millions of seniors whose health care depends on it. Contributors include a former Medicare trustee, a former Medicare administrator, and a former director of the Congressional Budget Office. Detailing Medicare's biggest problems, this team of top policy experts offer solutions based on personal freedom of choice, transparency of price and performance, and market competition among health plans and providers that will secure patients more affordable, more accountable, and higher quality medical care. They also address Medicare's reform needs and analyze the promising performance of the Medicare Advantage program. The authors outline Medicare's major financial problems and the best solutions for Medicare patients and taxpayers alike. While Medicare's accelerating spending is generating higher deficits and debt, standard cost-control strategies—such as payment reductions and price controls—jeopardize patients' access to high-quality care. Contributors: Joseph R. Antos, PhD; Doug Badger; Charles P. Blahous, PhD; Walton F. Francis; John C. Goodman, PhD; Edmund F. Haislmaier; Douglas Holtz-Eakin, PhD; Brian J. Miller, MD, MBA, MPH; Robert Emmet Moffit, PhD; Mark V. Pauly, PhD; Christopher M. Pope, PhD; Gail R. Wilensky, PhD.
Book Synopsis Developing an Information Infrastructure for the Medicare+Choice Program by : Institute of Medicine
Download or read book Developing an Information Infrastructure for the Medicare+Choice Program written by Institute of Medicine and published by National Academies Press. This book was released on 1999-02-09 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Book Synopsis Medicare's Quality Improvement Organization Program by : Institute of Medicine
Download or read book Medicare's Quality Improvement Organization Program written by Institute of Medicine and published by National Academies Press. This book was released on 2006-09-17 with total page 543 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare's Quality Improvement Organization Program is the second book in the new Pathways to Quality Health Care series. Focusing on performance improvement, it considers the history, role, and effectiveness of the Quality Improvement Organization (QIO) program and its potential to promote quality improvement within a changing health care delivery environment that includes standardized performance measures and new data collection and reporting requirements. This book carefully examines the QIOs that serve every state as well as the national program that guides and supports them. In addition, it highlights the important roles that a national program with private organizations in each state can play in promoting higher quality care. Medicare's Quality Improvement Organization Program looks closely at the technical assistance role of the QIO program and the need to encourage and support providers to improve their performance. By providing an in-depth assessment of the federal experience with quality improvement and recommendations for program improvement, this book helps point the way for those who strive to create higher quality and better value in health care. Intended for multiple audiences, Medicare's Quality Improvement Organization Program is essential reading for members of Congress, the federal executive branch, the QIOs, health care providers and clinicians, and stakeholder groups.
Book Synopsis Geographic Adjustment in Medicare Payment by : Institute of Medicine
Download or read book Geographic Adjustment in Medicare Payment written by Institute of Medicine and published by National Academies Press. This book was released on 2012-12-01 with total page 262 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare, the world's single largest health insurance program, covers more than 47 million Americans. Although it is a national program, it adjusts payments to hospitals and health care practitioners according to the geographic location in which they provide service, acknowledging that the cost of doing business varies around the country. Under the adjustment systems, payments in high-cost areas are increased relative to the national average, and payments in low-cost areas are reduced. In July 2010, the Department of Health and Human Services, which oversees Medicare, commissioned the IOM to conduct a two-part study to recommend corrections of inaccuracies and inequities in geographic adjustments to Medicare payments. The first report examined the data sources and methods used to adjust payments, and recommended a number of changes. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency applies the first report's recommendations in order to determine their potential effect on Medicare payments to hospitals and clinical practitioners. This report also offers recommendations to improve access to efficient and appropriate levels of care. Geographic Adjustment in Medicare Payment - Phase II:Implications for Access, Quality, and Efficiency expresses the importance of ensuring the availability of a sufficient health care workforce to serve all beneficiaries, regardless of where they live.
Book Synopsis The Affordable Care Act by : Tamara Thompson
Download or read book The Affordable Care Act written by Tamara Thompson and published by Greenhaven Publishing LLC. This book was released on 2014-12-02 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
Book Synopsis Developing an Information Infrastructure for the Medicare+Choice Program by :
Download or read book Developing an Information Infrastructure for the Medicare+Choice Program written by and published by . This book was released on 1999 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Healthy, Wealthy, and Wise by : John F. Cogan
Download or read book Healthy, Wealthy, and Wise written by John F. Cogan and published by Hoover Inst Press. This book was released on 2011 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care in the United States has made remarkable advances during the past forty years. Yet our health care system also has several well-known problems: high costs, significant numbers of people without insurance, and glaring gaps in quality and efficiency—and the Patient Protection and Affordable Care Act of 2010 is not the answer. This second edition of Healthy, Wealthy, and Wise details a better approach, offering fundamental reform alternatives centering on tax changes, insurance market changes, and redesigning Medicare and Medicaid. The book proposes five specific reforms to improve the ability of markets to create a lower-cost, higher-quality health care system that is responsive to the needs of individuals, including increasing individual involvement, deregulating insurance markets and redesigning Medicare and Medicaid, improving availability and quality of information, enhancing competition, and reforming the malpractice system. The authors show that, by promoting cost-conscious behavior and competition in both private markets and government programs such as Medicare and Medicaid, we can slow the rate of growth of health care costs, expand access to high-quality health care, and slow down runaway spending.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :030946921X Total Pages :161 pages Book Rating :4.3/5 (94 download)
Book Synopsis Health-Care Utilization as a Proxy in Disability Determination by : National Academies of Sciences, Engineering, and Medicine
Download or read book Health-Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Book Synopsis Medicare Prospective Payment and the Shaping of U.S. Health Care by : Rick Mayes
Download or read book Medicare Prospective Payment and the Shaping of U.S. Health Care written by Rick Mayes and published by JHU Press. This book was released on 2006-12-20 with total page 274 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the definitive work on Medicare’s prospective payment system (PPS), which had its origins in the 1972 Social Security Amendments, was first applied to hospitals in 1983, and came to fruition with the Balanced Budget Act of 1997. Here, Rick Mayes and Robert A. Berenson, M.D., explain how Medicare’s innovative payment system triggered shifts in power away from the providers (hospitals and doctors) to the payers (government insurers and employers) and how providers have responded to encroachments on their professional and financial autonomy. They conclude with a discussion of the problems with the Medicare Modernization Act of 2003 and offer prescriptions for how policy makers can use Medicare payment policy to drive improvements in the U.S. health care system. Mayes and Berenson draw from interviews with more than sixty-five major policy makers—including former Treasury secretary Robert Rubin, U.S. Representatives Pete Stark and Henry Waxman, former White House chief of staff Leon Panetta, and former administrators of the Health Care Financing Administration Gail Wilensky, Bruce Vladeck, Nancy-Ann DeParle, and Tom Scully—to explore how this payment system worked and its significant effects on the U.S. medical landscape in the past twenty years. They argue that, although managed care was an important agent of change in the 1990s, the private sector has not been the major health care innovator in the United States; rather, Medicare’s transition to PPS both initiated and repeatedly intensified the economic restructuring of the U.S. health care system.
Book Synopsis Medicare Hospice Benefits by : United States. Health Care Financing Administration
Download or read book Medicare Hospice Benefits written by United States. Health Care Financing Administration and published by . This book was released on 1993 with total page 6 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Report to the Congress, Medicare Payment Policy by : Medicare Payment Advisory Commission (U.S.)
Download or read book Report to the Congress, Medicare Payment Policy written by Medicare Payment Advisory Commission (U.S.) and published by . This book was released on 1998 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Price Setting and Price Regulation in Health Care by : OECD
Download or read book Price Setting and Price Regulation in Health Care written by OECD and published by OECD Publishing. This book was released on 2019-06-26 with total page 298 pages. Available in PDF, EPUB and Kindle. Book excerpt: The objectives of this study are to describe experiences in price setting and how pricing has been used to attain better coverage, quality, financial protection, and health outcomes. It builds on newly commissioned case studies and lessons learned in calculating prices, negotiating with providers, and monitoring changes. Recognising that no single model is applicable to all settings, the study aimed to generate best practices and identify areas for future research, particularly in low- and middle-income settings. The report and the case studies were jointly developed by the OECD and the WHO Centre for Health Development in Kobe (Japan).
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309468086 Total Pages :235 pages Book Rating :4.3/5 (94 download)
Book Synopsis Making Medicines Affordable by : National Academies of Sciences, Engineering, and Medicine
Download or read book Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-01 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Book Synopsis Who Should Pay for Medicare? by : Daniel Shaviro
Download or read book Who Should Pay for Medicare? written by Daniel Shaviro and published by University of Chicago Press. This book was released on 2004-03-06 with total page 185 pages. Available in PDF, EPUB and Kindle. Book excerpt: Good news first? The good news is that Americans today are living longer, in part because of continual advances in healthcare. But the bad news is that with our aging population larger than ever before, nothing is being done to ensure that we can continue to afford the increasing costs of care. How Medicare—with the Bush administration's reforms and a slumping economy—will meet the needs of its recipients without adequate financing is among the most pressing issues facing this country today. Daniel N. Shaviro sees the future of our national healthcare system as hinging on the issue of funding. The author of books on the economic issues surrounding Social Security and budget deficits, Shaviro is a skilled guide for anyone seeking to understand the financial aspects of government programs. Who Should Pay for Medicare? offers an accessible overview of how Medicare operates as a fiscal system. Discussions of Medicare reform often focus on the expansion of program treatment choices but not on the question of who should pay for Medicare's services. Shaviro's book addresses this critical issue, examining the underanalyzed dynamics of the significant funding gap facing Medicare. He gives a balanced, nonpartisan evaluation of various reform alternatives—considering everything from the creation of new benefits in this fiscal crunch to tax cuts to the demographic pressures we face and the issues this will raise when future generations have to pay for the care of today's seniors. Who Should Pay for Medicare? speaks to seniors who feel entitled to expanded coverage, younger people who wonder what to expect from the government when they retire, and Washington policy makers who need an indispensable guidebook to Medicare's future.
Book Synopsis Leadership by Example by : Institute of Medicine
Download or read book Leadership by Example written by Institute of Medicine and published by National Academies Press. This book was released on 2003-05-21 with total page 206 pages. Available in PDF, EPUB and Kindle. Book excerpt: The federal government operates six major health care programs that serve nearly 100 million Americans. Collectively, these programs significantly influence how health care is provided by the private sector. Leadership by Example explores how the federal government can leverage its unique position as regulator, purchaser, provider, and research sponsor to improve care - not only in these six programs but also throughout the nation's health care system. The book describes the federal programs and the populations they serve: Medicare (elderly), Medicaid (low income), SCHIP (children), VHA (veterans), TRICARE (individuals in the military and their dependents), and IHS (native Americans). It then examines the steps each program takes to assure and improve safety and quality of care. The Institute of Medicine proposes a national quality enhancement strategy focused on performance measurement of clinical quality and patient perceptions of care. The discussion on which this book focuses includes recommendations for developing and pilot-testing performance measures, creating an information infrastructure for comparing performance and disseminating results, and more. Leadership by Example also includes a proposed research agenda to support quality enhancement. The third in the series of books from the Quality of Health Care in America project, this well-targeted volume will be important to all readers of To Err Is Human and Crossing the Quality Chasm - as well as new readers interested in the federal government's role in health care.
