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...

Examines two generations of Social HMOs (S/HMO I and S/HMO II), models of managed care that incorporate additional long-term care benefits and care coordination services for Medicare beneficiaries. Finds that one of the three S/HMO I plans examined has implemented innovative geriatric...

In recent years, private plan options for Medicare beneficiaries have eroded substantially, with severely limited or no choice in most communities. The Medicare Modernization Act of 2003 (MMA) increased payment rates to plans. Although these increases have yet to cause the number of plan choices...

This case study of four well-regarded managed care organizations found that they made numerous innovations to improve care delivery for elderly Medicare beneficiaries with chronic illnesses and disabilities. Using the flexibility provided by capitation, they added new services in 1) screening to...

This case study of four well-regarded managed care organizations found that they made numerous innovations to improve care delivery for elderly Medicare beneficiaries with chronic illnesses and disabilities. Using the flexibility provided by capitation, they added new services in 1) screening to...

Reviews the early effects of the Benefits Improvement and Protection Act, which raised payment rates as of March 2001. Notes that only a few plans re-entered but those that did had important roles in their markets. As time goes on, effects are more likely to be seen in urban areas, since the...

One of the biggest challenges facing Medicare is educating beneficiaries about their insurance options. Data from a national survey indicate that most Medicare HMO and fee-for-service beneficiaries age 65 and up are aware of at least one source of information from the National Medicare Education...