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...

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...

Provides a statistical profile of Medicare's disabled population, highlighting socioeconomic and health and functional characteristics that policymakers need to consider to better meet this group's needs.

Finds that out-of-pocket health care spending for an enrollee in good health will rise by 20 percent in 2002, to $1,429, while costs for an enrollee in poor health will rise by 34 percent, to $4,783.

This publication reviews Medicare's limited experience with preferred provider organizations and private fee-for-service plans. It notes that fewer than 100,000 beneficiaries are now in such plans. The researchers also note concern about feasibility nationally and potentially higher costs.

Focuses on 66 large Metropolitan Statistical Areas across the country to analyze trends in plan withdrawals through 2002 and examine factors affecting withdrawals and ramifications for beneficiaries. Notes that local conditions make a difference in market dynamics, and withdrawals have affected...