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:
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:
Download or read book Medicare Advantage Organizations written by Jennifer R. Luong and published by DIANE Publishing. This book was released on 2010-10 with total page 14 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fed. govt.'s spending on the Medicare Advantage (MA) program has grown substantially in recent years, from $60 billion in 2006 and $77 billion in 2007 to $91 billion in 2008. MA org. provide health care coverage to Medicare beneficiaries through private health plans, thus offering an alternative to the original Medicare fee-for-service program. Payments to MA org. are, in part, based on the projected expenditures org. submit in their bids for providing Medicare-covered services, as well as actual enrollment and beneficiary health status. In 2008, MA org. spent less on medical expenses and earned more profits than projected. MA org. actual profit margin was 5% of total revenue which was $1.1 billion more in 2005 than MA org. had projected.
Download or read book Medicare Advantage Required Audits of Limited Value written by and published by DIANE Publishing. This book was released on 2007 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Advantage Organizations written by James C. Cosgrove and published by DIANE Publishing. This book was released on 2009 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare Advantage organizations (MAO) offer an alternative to Medicare fee-for-service (FFS) program. Payments to MAO are, in part, based on the revenue expenditures projections prior to the start of each contract year. On average, MAO projected they would spend 87% of their 2007 revenue on medical exp., 9% on non-med. exp., and that the remaining 4% would go to profits. The accuracy of MAO projections is important because these projections also affect the extent to which MA beneficiaries receive additional benefits not provided under FFS and the amounts beneficiaries pay in cost sharing and premiums. This report focuses on how MAO 2005 actual med. exp., non-med. exp., and profits compare to projections for the same year. Illus.
Download or read book Health Insurance and Managed Care written by Peter Reid Kongstvedt and published by Jones & Bartlett Publishers. This book was released on 2016 with total page 418 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Advantage written by James C. Cosgrove and published by DIANE Publishing. This book was released on 2010-05 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt: Questions have been raised about complaints that some Medicare Advantage (MA) org. and their agents inappropriately marketed their health plans to Medicare beneficiaries. Inappropriate marketing may include activities such as providing inaccurate info. about covered benefits and conducting prohibited marketing practices. The Centers for Medicare and Medicaid Services (CMS) is responsible for oversight of MA org. and their plans. This report examined: (1) the extent to which CMS has taken compliance and enforcement actions; (2) how CMS has helped beneficiaries affected by inappropriate marketing and the problems beneficiaries have encountered; and (3) info. CMS has about the extent of inappropriate marketing. Charts and tables.
Download or read book Accountable Care Organizations and the Medicare Shared Savings Program written by David Newman and published by DIANE Publishing. This book was released on 2010 with total page 23 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Private Fee for service Plans in Medicare Advantage written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2008 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Conditions of Participation for Hospitals written by United States. Social Security Administration and published by . This book was released on 1966 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Advantage Marketing and Sales written by United States. Congress. Senate. Special Committee on Aging and published by . This book was released on 2007 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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:
Download or read book Medicare Advantage Organizations written by James C. Cosgrove and published by . This book was released on 2008 with total page 14 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare Advantage (MA) organizations offer an alternative to the original Medicare fee-for-service (FFS) program. Payments to MA organizations are, in part, based on the revenue and expenditure projections MA organizations submit to the Centers for Medicare & Medicaid Services (CMS)-the agency that administers Medicare-prior to the start of each contract year. Once Medicare payments are determined, they are not modified based on differences between actual and projected expenses. In February 2008, we reported that, on average, MA organizations projected they would spend approximately 87 percent of their 2007 revenue on medical expenses, 9 percent on non-medical expenses, and that the remaining 4 percent would go to profits. The accuracy of MA organizations' projections is important because, in addition to determining Medicare payments, these projections also affect the extent to which MA beneficiaries receive additional benefits not provided under FFS and the amounts beneficiaries pay in cost sharing and premiums.
Download or read book Medicare Advantage Private Fee for Service Plans written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 2008 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Coverage of Diabetes Supplies Services written by and published by . This book was released on 2002 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Managed Care written by James C. Cosgrove and published by DIANE Publishing. This book was released on 2010-10 with total page 35 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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 org. offering cost plans also offer MA plans; and (4) described concerns cost plans have about converting to MA plans. Charts and tables.
Download or read book Accounting for Social Risk Factors in Medicare Payment written by and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver. Accounting For Social Risk Factors in Medicare Payment: Data is the fourth in a series of five brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report provides guidance on data sources for and strategies to collect data on indicators of social risk factors that could be accounted for Medicare quality measurement and payment programs"--Publisher's website.
