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:
Download or read book Improving the Medicare Market written by and published by . This book was released on 1996 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
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.
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 75 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.
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.
Download or read book Improving the Quality of Long Term Care written by Institute of Medicine and published by National Academies Press. This book was released on 2001-02-27 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
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.
Download or read book Understanding Medicare Managed Care written by Louis F. Rossiter and published by . This book was released on 2001 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: A reference for health-care executives and physicians as well as managers, administrators, and staff of Medicare managed-care plans, providing a structure for plotting a long-term plan to compete in this market. In addition to describing the economics of the current system, including trends and key players, the book covers strategic planning and marketing, including issues such as pricing and the capitation dollar, benefit design, and techniques of quality and cost control. Finally, the work speculates about future changes in the system and the health-care marketplace and their implications for health plan participation. The author is deputy secretary for Health and Human Resources, Commonwealth of Virginia, and previously was a member of the health economics faculty of Virginia Commonwealth U. Annotation copyrighted by Book News, Inc., Portland, OR
Download or read book Medicare written by Institute of Medicine and published by National Academies Press. This book was released on 1990-02-01 with total page 462 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care for the elderly American is among our nation's more pressing social issues. Our society wishes to ensure quality health care for all older people, but there is growing concern about our ability to maintain and improve quality in the face of efforts to contain health care costs. Medicare: A Strategy for Quality Assurance answers the U.S. Congress' call for the Institute of Medicine to design a strategic plan for assessing and assuring the quality of medical care for the elderly. This book presents a proposed strategic plan for improving quality assurance in the Medicare program, along with steps and timetables for implementing the plan by the year 2000 and the 10 recommendations for action by Congress. The book explores quality of careâ€"how it is defined, measured, and improvedâ€"and reviews different types of quality problems. Major issues that affect approaches to assessing and assuring quality are examined. Medicare: A Strategy for Quality Assurance will be immediately useful to a wide audience, including policymakers, health administrators, individual providers, specialists in issues of the older American, researchers, educators, and students.
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 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.
Download or read book Controlling Costs and Changing Patient Care written by Institute of Medicine and published by National Academies Press. This book was released on 1989-01-01 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
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:
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.
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 Systems Practices for the Care of Socially At Risk Populations written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-05-07 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.
