In the absence of broad federal health care reform, interest has grown in local solutions to the problem of providing health care to the uninsured. Community-based donated medical care models have emerged as one alternative. The authors examine the early experience of a donated care program in...

In recent years, many health maintenance organizations (HMOs)have exited the market for Medicare managed care; since 1998, the number of participating plans has fallen from 346 to 174. As a result of this reduced participation by HMOs, hundreds of thousands of Medicare beneficiaries have been...

In recent years, many health maintenance organizations (HMOs)have exited the market for Medicare managed care; since 1998, the number of participating plans has fallen from 346 to 174. As a result of this reduced participation by HMOs, hundreds of thousands of Medicare beneficiaries have been...

We seek to understand the relationship between employer decisions regarding which health plans firms choose to offer to their employees and the performance of those plans. We measure performance using data from the Health Plan Employer Data Information Set (HEDIS) and the Consumer Assessment of...

Reviews Tennessee's experience setting, monitoring, and updating capitation rates for Medicaid managed behavioral health care and draws lessons for other states. Finds that the initial behavioral health rate was inadequate, primarily because of the way available information was used, rather than...

A study recently published concluded that populations with different types of public health insurance have rates of receiving treatment for a substance use disorder that range from two to four times greater than the privately insured. The study was funded by the Substance Abuse and Mental Health...

With higher payments and expanded private-plan authority, Medicare Advantage (MA) has caused the market to grow. One in three Medicare beneficiaries with Part D now gets this coverage through MA. Analysis of the sources of and reasons for enrollment growth suggest a troubling report card....