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Medicare Advantage

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Journal Article
Journal of Health Politics, Policy and Law (1 April 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
Journal of Health Politics, Policy and Law (1 June 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...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2005) 30 (3): 453–474.
Published: 01 June 2005
... 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
Journal of Health Politics, Policy and Law (1 August 2018) 43 (4): 707–730.
Published: 01 August 2018
... Progressive reform Medicare buy-in Medicare Advantage marketplaces universal coverage There is no way to understand the path of health care reform in the United States without understanding the role of counterreform. Every successful progressive reform in health policy has been adopted in response to...
Journal Article
Journal of Health Politics, Policy and Law (1 October 1998) 23 (5): 867–870.
Published: 01 October 1998
...James Patrick Fennelly Beaufort B. Longest, Jr. Seeking Strategic Advantage through Health Policy Analysis. Chicago: Health Administration, 1996. 169 pp. $40.00 cloth. Copyright © 1998 by Duke University Press 1998 Reviews 867 Beaufort...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2015) 40 (4): 923–931.
Published: 01 August 2015
...Harold Pollack Abstract Medicare for All, ideally implemented, could offer powerful advantages over our current health care financial system. Unfortunately, the political obstacles to such a system are formidable and are likely to remain so for decades. More to the point, a politically viable...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2001) 26 (1): 37–80.
Published: 01 February 2001
...Michael Gusmano; Mark Schlesinger The Medicare program incorporates a number of functions that go beyond providing health insurance to its beneficiaries. These activities, which we refer to as “collateral” functions, may have important health consequences but are also an increasing source of...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2018) 43 (3): 401–425.
Published: 01 June 2018
... Condition Reduction Program, Medicare Advantage Quality Star Rating Program, Medicare Shared Savings Program, Physician Value-Based Payment Modifier Program, End-Stage Renal Disease Quality Incentive Program, Skilled Nursing Facility Value-Based Purchasing Program, and Home Health Value-Based Purchasing...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2016) 41 (4): 697–716.
Published: 01 August 2016
... 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 in the traditional fee-for-service benefit. At the time the hospice benefit was created...
Journal Article
Journal of Health Politics, Policy and Law (1 April 2014) 39 (2): 467–482.
Published: 01 April 2014
... recent years. In 2005, 13 percent of Medicare beneficiaries were in such plans. By 2013, over one in four Medicare beneficiaries (28 percent) had enrolled in a private insurance plan under Medicare Advantage, and enrollment growth continued apace despite cuts to plan payments under the Affordable Care...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2013) 38 (3): 479–504.
Published: 01 June 2013
... Medicare), while the NHEA reports those costs as well as the administrative costs incurred by Medicare Advantage plans and Part D plans. Second, I detail the debate about Medicare’s administrative costs and present examples of statements by participants on both sides of the political aisle that are...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2011) 36 (3): 555–563.
Published: 01 June 2011
...-reform/when-medicare-is-the-piggy-bank (accessed October 27, 2010) . Berenson R. A. Dowd B. . 2009 . Medicare Advantage Plans at a Crossroads — Yet Again . Health Affairs (online) 28 : W29 – W40 . Blendon R. J. Benson J. M. . 2010 . Health Care in the 2010 Election...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2015) 40 (4): 911–921.
Published: 01 August 2015
... ways to discourage the enrollment, and encourage the disenrollment, of high-cost individuals. Risk adjustment, however, has already been attempted in the Medicare Advantage program and the Medicare drug program, and several studies have found that it is hard to achieve successful, equitable risk...
Journal Article
Journal of Health Politics, Policy and Law (1 April 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 and...
Journal Article
Journal of Health Politics, Policy and Law (1 December 2008) 33 (6): 1079–1106.
Published: 01 December 2008
... VA-like drug prices for more Medicare beneficiaries? The answer to the first question suggests one to the second. The VA and Medicare prescription drug programs each advantage patients with different needs and concerns. The VA’s might be preferred by those who need or want coverage from...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2015) 40 (4): 761–796.
Published: 01 August 2015
... 2005 with a set of ten process-of-care measures for heart attack, heart failure, pneumonia, and surgical care ■ Now has several additional quality measures, including measures for hospital outpatient facilities Medicare Advantage Plan Bonuses Medicare ■ In 2012 the ACA allowed CMS to implement a...
Journal Article
Journal of Health Politics, Policy and Law (1 December 2004) 29 (6): 1187–1226.
Published: 01 December 2004
... occur in no more than six geographic areas, each of which has two or more Medicare Advantage (the new name for the Medicare managed care program) plans that enroll 25 percent or more of the eligible beneficiaries in the area. ■ Medicare payments to plans will be based on a weighted average...
Journal Article
Journal of Health Politics, Policy and Law (1 April 2007) 32 (2): 221–246.
Published: 01 April 2007
... traditional Medicare (Hurley, Strunk, and White 2004). If competition within Medicare is a fair fight, one would expect the mother of all PPOs to win the contest. If that is true for seniors, it should be true for the working population as well. Traditional Medicare has some clear surface advantages...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2011) 36 (4): 649–689.
Published: 01 August 2011
... Design of Competitive Bidding in Medicare Advantage . Journal of Health Politics, Policy and Law 32 : 317 – 347 . Chiles L. 1998 . Letter to Nancy-Ann Min DeParle, administrator of the Health Care Financing Administration, from the governor of Florida . May 22 . Christianson J...
Journal Article
Journal of Health Politics, Policy and Law (1 April 2007) 32 (2): 247–291.
Published: 01 April 2007
..., Christie Provost. 2005. Medicare Advantage SNPs: A New Opportunity for Integrated Care? National Health Policy Forum Issue Brief No. 808, November 11. Washington, DC: George Washington University. www.nhpf.org/pdfs_ib/IB808_SNP_11-11-05.pdf . Princeton Survey Research Associates. 1996 . Survey...