Read Books Online and Download eBooks, EPub, PDF, Mobi, Kindle, Text Full Free.
Medicare Advantage Relationship Between Benefit Package Designs And Plans Average Beneficiary Health Status
Download Medicare Advantage Relationship Between Benefit Package Designs And Plans Average Beneficiary Health Status full books in PDF, epub, and Kindle. Read online Medicare Advantage Relationship Between Benefit Package Designs And Plans Average Beneficiary Health Status ebook anywhere anytime directly on your device. Fast Download speed and no annoying ads. We cannot guarantee that every ebooks is available!
Book Synopsis Medicare Advantage: Relationship Between Benefit Package Designs and Plans’ Average Beneficiary Health Status by : James C. Cosgrove
Download or read book Medicare Advantage: Relationship Between Benefit Package Designs and Plans’ Average Beneficiary Health Status written by James C. Cosgrove and published by DIANE Publishing. This book was released on 2010-11 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nearly 11 million Medicare beneficiaries are enrolled in Medicare Advantage (MA), Medicare's private health insur. option. Benefits vary by MA plan and may include coverage for services not avail. in traditional Medicare. To ensure MA plan benefit package designs do not discriminate against beneficiaries in poor health with high expected health care costs, the Centers for Medicare & Medicaid Serv. (CMS) reviews and approves all benefit packages yearly. This report examined: (1) MA plan benefit packages by average health status of plans' enrolled beneficiaries; (2) dist. and characteristics of MA plans by average beneficiary health status; and (3) CMS's process for ensuring that benefit packages do not discriminate with respect to health status. Charts and tables.
Book Synopsis Medicare Advantage by : U.s. Government Accountability Office
Download or read book Medicare Advantage written by U.s. Government Accountability Office and published by . This book was released on 2017-08-17 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nearly 11 million Medicare beneficiaries are enrolled in Medicare Advantage (MA), Medicare's private health insurance option. Benefits vary by MA plan and may include coverage for services not available in traditional Medicare. To ensure MA plan benefit package designs do not discriminate against beneficiaries in poor health with high expected health care costs, the Centers for Medicare & Medicaid Services (CMS) reviews and approves all benefit packages yearly.GAO examined (1) MA plan benefit packages by average health status of plans' enrolled beneficiaries, (2) distribution and characteristics of MA plans by average beneficiary health status, and (3) CMS's process for ensuring that benefit packages do not discriminate with respect to health status. Using 2008 data on beneficiaries' expected health care costs, the most recent data available, GAO sorted 2,899 plans enrolling 7.5 million beneficiaries into three groups: good health (below-average expected costs), average health, and poor health (above-average expected costs). GAO then analyzed MA plan benefit packages by health group and reviewed CMS documentation and interviewed agency officials on CMS's benefit package review process. GAO did not determine whether plans structured benefit packages..."
Author :United States Government Accountability Office Publisher :Createspace Independent Publishing Platform ISBN 13 :9781983725005 Total Pages :44 pages Book Rating :4.7/5 (25 download)
Book Synopsis Medicare Advantage by : United States Government Accountability Office
Download or read book Medicare Advantage written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2018-01-11 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare Advantage: Relationship between Benefit Package Designs and Plans' Average Beneficiary Health Status
Book Synopsis Medicare Advantage by : United States. Government Accountability Office
Download or read book Medicare Advantage written by United States. Government Accountability Office and published by . This book was released on 2010 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare Advantage by : James C. Cosgrove
Download or read book Medicare Advantage written by James C. Cosgrove and published by DIANE Publishing. This book was released on 2008-07 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2006, the fed. govt. spent $59 billion on Medicare Advantage (MA) plans, an alternative to the original Medicare fee-for-service (FFS) program. Although health plans were originally envisioned as a source of Medicare savings, such plans have generally increased program spending. Payments to MA plans have been estimated to be 12% greater than what Medicare would have spent in 2006 had MA beneficiaries been enrolled in Medicare FFS. This report examines for 2007: (1) MA plan¿s projected rebate allocations; (2) additional benefits MA plans commonly covered & their costs; (3) MA plans¿ projected cost sharing; & (4) MA plans¿ allocation of projected revenues and expenses. Tables and graphs.
Download or read book The Medicare Handbook written by and published by . This book was released on 1989 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare Advantage: Higher Spending Relative to Medicare Fee-for-Service May Not Ensure Lower Out-of-Pocket Costs for Beneficiaries by : James Cosgrove
Download or read book Medicare Advantage: Higher Spending Relative to Medicare Fee-for-Service May Not Ensure Lower Out-of-Pocket Costs for Beneficiaries written by James Cosgrove and published by DIANE Publishing. This book was released on 2008-06 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: Although private health plans were originally envisioned in the 1980s as a potential source of Medicare savings, such plans have generally increased program spending. In 2006, Medicare paid $59 billion to Medicare Advantage (MA) plans -- an estimated $7.1 billion more than Medicare would have spent if MA beneficiaries had received care in Medicare fee-for-service (FFS). MA plans receive a per member per month payment to provide services covered under Medicare FFS. For this testimony, the author examined MA plans¿: (1) projected allocation of rebates; (2) projected cost sharing; and (3) projected revenues and expenses. Charts and tables.
Book Synopsis Designing a Premium Support System for Medicare by : Lyle Nelson
Download or read book Designing a Premium Support System for Medicare written by Lyle Nelson and published by . This book was released on 2006 with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt: And introduction -- Traditional Medicare and private health plans -- Issues in designing a premium support system for Medicare -- Health care systems that are similar to premium support -- Potential effects of selected approaches to premium support -- Technical aspects of the analysis -- Supplementary tables.
Author :United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health Publisher : ISBN 13 : Total Pages :96 pages Book Rating :4.:/5 (319 download)
Book Synopsis Strengthening Medicare for Seniors by : United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health
Download or read book Strengthening Medicare for Seniors written by United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health and published by . This book was released on 2013 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare Advantage by : U.s. Government Accountability Office
Download or read book Medicare Advantage written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-08-17 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The Centers for Medicare & Medicaid Services (CMS) pays plans in Medicare Advantage (MA)-the private plan alternative to Medicare fee-for-service (FFS)-an amount per beneficiary that is adjusted to reflect beneficiary health status. This adjustment, called risk adjustment, helps ensure that health plans have the same financial incentive to enroll and care for beneficiaries regardless of their health status. In 2010, CMS announced plans to revise the major medical conditions included in its principal risk-adjustment model-the community model-and add a model for new enrollees in chronic condition special needs plans (C-SNP), which target beneficiaries with certain severe or disabling chronic conditions. CMS began using the C-SNP new enrollee model in 2011, in place of the general new enrollee model, to adjust MA payments for new Medicare beneficiaries who enroll in a C-SNP. GAO was asked to examine the accuracy of these models for high-risk beneficiaries. Using data for a nationally representative sample of 2007 FFS beneficiaries, GAO computed the amount that expenditure estimates were above or below actual expenditures for 2007, the most recent data available at the time. GAO compared the accuracy of the current and revised community models for three high-risk groups: beneficiaries with multiple chronic conditions, with low income, and with dementia. GAO compared the accuracy of the general and C-SNP new enrollee models for new enrollees eligible to enroll in a C-SNP. What GAO Found The effect of CMS's revised community model on payment accuracy varied for the high-risk groups studied. Specifically, compared with the current community model, the revised community model slightly reduced the accuracy of MA payment adjustments for beneficiaries with multiple chronic conditions by $164, or about 1 percent of average actual expenditures. For beneficiaries with low income, the accuracy of the revised and the current community models was similar: estimates differed by $5, o..."
Book Synopsis Handbook of Health Economics by : Mark V. Pauly
Download or read book Handbook of Health Economics written by Mark V. Pauly and published by Elsevier. This book was released on 2012-01-05 with total page 1149 pages. Available in PDF, EPUB and Kindle. Book excerpt: "As a relatively new subdiscipline of economics, health economics has made many contributions to areas of the main discipline, such as insurance economics. This volume provides a survey of the burgeoning literature on the subject of health economics." {source : site de l'éditeur].
Download or read book Health Care Financing Review written by and published by . This book was released on 2002 with total page 636 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Care Without Coverage by : Institute of Medicine
Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
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 Medicare Advantage by : United States. Government Accountability Office
Download or read book Medicare Advantage written by United States. Government Accountability Office and published by . This book was released on 2011 with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare & Medicaid Services (CMS) pays plans in Medicare Advantage (MA)--the private plan alternative to Medicare fee-for-service (FFS)--an amount per beneficiary that is adjusted to reflect beneficiary health status. This adjustment, called risk adjustment, helps ensure that health plans have the same financial incentive to enroll and care for beneficiaries regardless of their health status. In 2010, CMS announced plans to revise the major medical conditions included in its principal risk-adjustment model--the community model--and add a model for new enrollees in chronic condition special needs plans (C-SNP), which target beneficiaries with certain severe or disabling chronic conditions. CMS began using the C-SNP new enrollee model in 2011, in place of the general new enrollee model, to adjust MA payments for new Medicare beneficiaries who enroll in a C-SNP. GAO was asked to examine the accuracy of these models for high-risk beneficiaries. Using data for a nationally representative sample of 2007 FFS beneficiaries, GAO computed the amount that expenditure estimates were above or below actual expenditures for 2007, the most recent data available at the time. GAO compared the accuracy of the current and revised community models for three high-risk groups: beneficiaries with multiple chronic conditions, with low income, and with dementia. GAO compared the accuracy of the general and C-SNP new enrollee models for new enrollees eligible to enroll in a C-SNP.
Book Synopsis Medicare Advantage by : U. s. Government Accountability Office
Download or read book Medicare Advantage written by U. s. Government Accountability Office and published by CreateSpace. This book was released on 2012-08-13 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: The effect of CMS's revised community model on payment accuracy varied for the high-risk groups studied. Specifically, compared with the current community model, the revised community model slightly reduced the accuracy of MA payment adjustments for beneficiaries with multiple chronic conditions by $164, or about 1 percent of average actual expenditures. For beneficiaries with low income, the accuracy of the revised and the current community models was similar: estimates differed by $5, or less than 0.1 percent of average actual expenditures. For beneficiaries with dementia, the revised community model substantially improved the accuracy of MA payment adjustments by $2,674, or about 16 percent of average actual expenditures. Compared with the general new enrollee model, the C-SNP new enrollee model substantially improved the accuracy of MA payment adjustments for new enrollees with C-SNP conditions, but considerable inaccuracy in the model's estimates remains for certain groups. The amount by which accuracy improved was similar across 14 severe or disabling chronic conditions: about $2,500. This reflects the design of the C-SNP new enrollee model, which increases expenditure estimates from the general new enrollee model by an amount that does not depend on beneficiaries' medical conditions. However, the C-SNP new enrollee model still underestimated expenditures for C-SNP-eligible new enrollees, on average, by about $1,500 and by more than $15,000 for beneficiaries who had certain conditions, such as end-stage liver disease or stroke. The C-SNP new enrollee model's results varied depending on the number of severe or disabling conditions the beneficiary had. Specifically, the model reduced the accuracy of estimated expenditures for new enrollees with only 1 severe or disabling condition by about 62 percent of average actual expenditures but improved the accuracy for those with 4 or more conditions by about 8 percent. However, the C-SNP new enrollee model still underestimated expenditures for beneficiaries with 4 or more conditions by over $20,000. Accurate risk adjustment is particularly important for certain high-risk beneficiary groups that are more challenging and costly to treat and may benefit particularly from the coordination of care MA plans can provide. The decision to implement the revised community model that adjusts for dementia will depend on CMS's assessment of the advantages of more accurate payment adjustment for beneficiaries with dementia compared with the potential increase in the discretionary coding of dementia because of revised coding guidelines for Alzheimer's disease dementia published in April 2011. Additionally, while the introduction of the C-SNP new enrollee model improved the accuracy of payment adjustments for eligible new enrollees, on average, the model still considerably underestimated expenditures for certain groups, which could place plans that disproportionately enroll beneficiaries in these groups at a relative financial disadvantage. In its comments on a draft of this report, CMS suggested that GAO assess the overall accuracy of the current risk adjustment model. GAO did not assess overall model accuracy because such an analysis was not within the scope of GAO's work and would have required additional data.
Book Synopsis Free for All? by : Joseph P. Newhouse
Download or read book Free for All? written by Joseph P. Newhouse and published by Harvard University Press. This book was released on 1993 with total page 516 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the most important health insurance study ever conducted researchers at the RAND Corporation devised all experiment to address two key questions in health care financing: how much more medical care will people use if it is provided free of charge, and what are the consequences for their health? For three- or five-year periods the experiment measured both use and health outcomes in populations carefully selected to be representative of both urban and rural regions throughout the United States. Participants were enrolled in a range of insurance plans requiring different levels of copayment for medical care, from zero to 95 percent. The researchers found that in plans that reimbursed a higher proportion of the bill, patients used substantially more services - indeed, those who paid nothing used 40 percent more services than those required to pay a high deductible - but the effect on the health of the average person was negligible. In addition, participants who were assigned at random to a well-established health maintenance organization used hospitals substantially less than those in the fee-for-service system, again with no measurable effect on the health of the average person. This book collects in one place for the first time results previously dispersed through many journals over many years. Drawing comprehensive, coherent conclusions from an immense amount of data, it is destined to be a classic work serving as an invaluable reference for all those concerned with health care policy - health service researchers, policymakers in both the public and the private sectors, and students.
