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Medicare Advantage

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Journal Article
J Health Polit Policy Law (2007) 32 (2): 317–347.
Published: 01 April 2007
...John H. Cawley; Andrew B. Whitford In 2003, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act, which required that in 2006 the Centers for Medicare and Medicaid Services (CMS) implement a system of competitive bids to set payments for the Medicare Advantage program...
Journal Article
J Health Polit Policy Law (2021) 46 (4): 627–639.
Published: 01 August 2021
..., while Medicare Advantage plans successfully compete with traditional Medicare only because their payment rates are tied by regulation to those in the traditional Medicare program. However, Medicare has not succeeded in implementing new, value-based payment approaches that also would serve as models...
Journal Article
J Health Polit Policy Law (2016) 41 (3): 315–354.
Published: 01 June 2016
...Andrew S. Kelly Abstract In 2014, Medicare Advantage (MA) enrollment surpassed 30 percent of eligible beneficiaries. Twenty-five years earlier, enrollment hovered at just 3 percent. The expansion of private Medicare plans presents a puzzling instance of policy change within Medicare—a program long...
FIGURES | View All (6)
Journal Article
J Health Polit Policy Law (2005) 30 (3): 453–474.
Published: 01 June 2005
... or explaining costs of health care for defined populations or for evaluating retrospectively the performance of providers who care for them. Although the federal government seems to have settled on an approach to RA for Medicare Advantage programs, adoption and implementation of RA techniques elsewhere have...
Journal Article
J Health Polit Policy Law (2016) 41 (4): 697–716.
Published: 01 August 2016
... (Stevenson 2012 ). Since its creation in 1983, the Medicare hospice benefit has been “carved out” of the Medicare Advantage managed care program. Medicare Advantage plans are capitated by Medicare and must offer a benefit package that is actuarially comparable to that available to beneficiaries...
Journal Article
J Health Polit Policy Law (2019) 44 (6): 937–954.
Published: 01 December 2019
... by the authors of provider network data provided by Vericred under contract with the Robert Wood Johnson Foundation further illustrates this point. Including the vast majority of networks for ACA and Medicare Advantage plans nationwide, the data indicate that of the about 2.6 million providers in the data set...
Journal Article
J Health Polit Policy Law (2013) 38 (3): 479–504.
Published: 01 June 2013
...’ measure reports only the administrative costs incurred by the federal government (i.e., by CMS as well as other federal agencies that contribute to the operation of Medicare), while the NHEA reports those costs as well as the administrative costs incurred by Medicare Advantage plans and Part D...
Journal Article
J Health Polit Policy Law (2014) 39 (2): 467–482.
Published: 01 April 2014
... Advantage, and enrollment growth continued apace despite cuts to plan payments under the Affordable Care Act. Further, Medicare's Part D benefit for prescription drug coverage is made up entirely of private plans paid by the federal government. This part of Medicare is, in other words, already privatized...
Journal Article
J Health Polit Policy Law (2018) 43 (4): 707–730.
Published: 01 August 2018
... Progressive reform Medicare buy-in Medicare Advantage marketplaces universal coverage References Berenson Robert A. , Ginsburg Paul B. , Christianson Jon B. , and Yee Tracy . 2012 . “ The Growing Power of Some Providers to Win Steep Payment Increases from Insurers Suggests...
Journal Article
J Health Polit Policy Law (2021) 46 (4): 535–547.
Published: 01 August 2021
... Medicare Advantage. All these changes brought Biden's plan much closer to his progressive campaign rivals'. In 2009, the public option was tacked onto a proposal drawn largely from the Massachusetts experience. Today, it is at the center of an integrated vision that would fundamentally transform...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 689–703.
Published: 01 August 2015
... Number of ACOs by County Figure 2. Number of ACOs by County Turning to Medicare, we find similar patterns. The share of Medicare beneficiaries who are enrolled in Medicare Advantage is positively associated with the share participating in a Medicare ACO, but the result is not quite statistically...
FIGURES
Journal Article
J Health Polit Policy Law (2014) 39 (2): 263–293.
Published: 01 April 2014
... and payments include reductions to annual payment updates for some providers, such as acute care hospitals, and increases in payment to other providers, such as primary care physicians in underserved areas. The ACA also reduces subsidies to commercial Medicare Advantage plans and increases the Medicare tax...
FIGURES | View All (6)
Journal Article
J Health Polit Policy Law (2020) 45 (5): 847–861.
Published: 01 October 2020
... with progressively more expansive regulatory revisions under the Trump administration (CMS 2019 ), has permitted Medicare Advantage (MA) plans to offer nonmedical supportive services, including nonmedical transportation, home-delivered meals, adult day services, nonmedical in-home support, respite care, and home...
Journal Article
J Health Polit Policy Law (2011) 36 (3): 555–563.
Published: 01 June 2011
... in phy- sician reimbursements, will either Obama’s HHS or Congress want to impose real or perceived pain prior to the 2014 general election? Our guess is no. 2. Will Seniors Understand Medicare “Reductions” to Private Health Plans? Payment reductions to Medicare Advantage (MA...
Journal Article
J Health Polit Policy Law (2020) 45 (6): 1107–1136.
Published: 01 December 2020
... public and private insurers have recognized the implications of transportation barriers and have incorporated nonemergency medical transportation into their plan designs. These insurers include, for example, some Accountable Care Organizations (Fraze et al. 2016 ), Medicare Advantage plans (Pope 2016...
FIGURES | View All (6)
Journal Article
J Health Polit Policy Law (2014) 39 (1): 209–235.
Published: 01 February 2014
.... Shafir E. “Behavioral Economics and Marketing in Aid of Decision Making among the Poor.” Journal of Public Policy and Marketing 2006 25 8 23 Biles B. Nicholas L. H. Guterman S. Medicare Beneficiary Out-of-Pocket Costs: Are Medicare Advantage Plans a Better Deal? 2006...
Journal Article
J Health Polit Policy Law (2007) 32 (2): 187–219.
Published: 01 April 2007
... Dallek, and Lauren Hersch Nicholas. 2004. Medicare Advantage: Déjà Vu All Over Again. Web exclusive, Health Affairs, December 15. content.healthaffairs.org/cgi/reprint/hlthaff.w4.586v1 . Boards of Trustees. 2006 . 2006 Annual Report of the Boards of Trustees of the Federal Hospital Insurance...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 745–760.
Published: 01 August 2015
... for Medicare. 3. The patient can waive that right by joining a private Medicare Advantage plan. References Anderson Gerard F. , Reinhardt Uwe E. , Hussey Peter S. , and Petrosyan Varduhi . 2003 . “ It's the Prices, Stupid: Why the United States Is So Different from Other...
Journal Article
J Health Polit Policy Law (2010) 35 (6): 961–997.
Published: 01 December 2010
... if low-­enrollment Part D plans were eliminated. Rice and Cummings  ■  Reducing Drug Plans for Seniors  969   tition on the basis of quality could decline. A number of possible options of this sort have been proposed by Gold (2009), in the context of the Medicare Advantage (Part C...
Journal Article
J Health Polit Policy Law (2018) 43 (1): 5–18.
Published: 01 February 2018
... the rule, a significant exclusion in light of the lower prices the VA pays on many costly drugs. Prices charged for pharmaceuticals covered by Medicare Part D, including through Medicare Advantage plans, are also exempt (42 U.S.C. § 1396r-8(c)(1)(C)(i)(I)–(VI)). Discounts obtained by these purchasers need...