This data spotlight examines trends in benefits and cost-sharing for Medicare Advantage plans in 2010, including the wide variations found across plans and the rapid increase in cost sharing requirements for some benefits, including stays in skilled nursing facilities. It also examines the...

This spotlight examines enrollment trends in Medicare Advantage plans, including health maintenance organizations (HMOs), preferred provider organizations (PPOs), and private fee-for-service (PFFS) plans. Despite the availability of many private Medicare Advantage plans, enrollment is highly...

Quality improvement collaboratives have become a common strategy for improving health care. This paper uses social network analysis to study the relationships among organizations participating in a large scale public–private collaboration among major health plans to reduce racial and...

This Data Spotlight reviews trends in Medicare Advantage plan offerings, choices available to beneficiaries, and the premiums and selected characteristics of the available plans in 2012. Despite concerns about the potential effects of reductions in payments included in the 2010 health reform...

Notes that Florida's Medicaid managed care program continues to face many of the same issues as it has historically: demands of litigation diverted agency resources and slowed progress in enhancing oversight and education. The joint use of HMOs and PCCM components, combined with other issues,...

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....

Examines M+C participation issues from the perspective of eight national firms that account for more than 70 percent of M+C enrollment nationwide. Notes that M+C products generally do not represent a major line of business for most firms, with the exception of Humana and PacifiCare, where M+C...

Previous efforts by Congress to expand the role of private plans in Medicare have met with limited success. Although the same fate may befall Medicare Advantage, the political environment has changed, and powerful political interests now support Medicare privatization. Only time will tell...

The role of private health plans in Medicare expanded substantially in 2004 under the Medicare Modernization Act, which builds on plan experience under Medicare+Choice, created in 1997 to offer more managed care choices for beneficiaries and recently renamed Medicare Advantage. Although sponsors...