The Medicare Handbook


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Improving the Medicare Market


Book Description

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.




Health Insurance is a Family Matter


Book Description

Health Insurance is a Family Matter is the third of a series of six reports on the problems of uninsurance in the United Sates and addresses the impact on the family of not having health insurance. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well-being of all members of a family may be adversely affected if any family member lacks coverage. It concludes with the finding that uninsured children have worse access to and use fewer health care services than children with insurance, including important preventive services that can have beneficial long-term effects.







Medicare+Choice Program


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Status of the Medicare+Choice Program


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The Medicare+Choice Program After One Year


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The Medicare and Choice Program After One Year


Book Description

Hearing on the first year of the Medicare & Choice options, which are coordinate care plans. Witnesses: Bruce E. Bradley, Dir., Managed Care Plans, General Motors Corp.; Judith Feder, Prof. of Public Policy, Georgetown Univ.; Bill Gradison, Pres., Health Insurance Assoc. of Amer.; Michael Hash, Deputy Administrator, Health Care Financing Admin.; Karen Ignagni, Pres. & CEO, Amer. Assoc. of Health Plans; Patricia A. Riley, V.P., Government Relations, Allina Health System; Donald P. Sacco, CEO, Blue Cross Blue Shield of Oregon, accompanied by Mary Nell Lehnhard, Sr. V.P. of Blue Cross Blue Shield Assoc.




The Medicare Advantage Program


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Medicare Advantage


Book Description

Questions have been raised about complaints that some Medicare Advantage (MA) org. and their agents inappropriately marketed their health plans to Medicare beneficiaries. Inappropriate marketing may include activities such as providing inaccurate info. about covered benefits and conducting prohibited marketing practices. The Centers for Medicare and Medicaid Services (CMS) is responsible for oversight of MA org. and their plans. This report examined: (1) the extent to which CMS has taken compliance and enforcement actions; (2) how CMS has helped beneficiaries affected by inappropriate marketing and the problems beneficiaries have encountered; and (3) info. CMS has about the extent of inappropriate marketing. Charts and tables.