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Journal Article

Medicare Coverage, Medicare Costs, and Medical Technology

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Gloria Ruby, H. David Banta, Anne Kesselman Burns
J Health Polit Policy Law (1985) 10 (1): 141–156.
DOI: https://doi.org/10.1215/03616878-10-1-141
Published: 01 February 1985
...Gloria Ruby; H. David Banta; Anne Kesselman Burns One possible approach to containing Medicare costs involves explicit changes in Medicare's coverage policy with respect to medical technology. This paper first describes the development and diffusion of medical technology in general...
View articletitled, <span class="search-highlight">Medicare</span> Coverage, <span class="search-highlight">Medicare</span> Costs, and Medical Technology View PDF for article titled, <span class="search-highlight">Medicare</span> Coverage, <span class="search-highlight">Medicare</span> Costs, and Medical Technology
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Figure 1. The Growth of Medicare Managed Care, 1985–2013. Enrollment in Medicare Managed Care as a Percent of Total Medicare Enrollment. / Sources: Jacobson et al. 2015; McGuire, Newhouse, and Sinaiko 2011; Lundy, Levitt, and Wang 2002

The Growth of Medicare Managed Care, 1985–2013. Enrollment in Medicare Mana...

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in Boutique to Booming: Medicare Managed Care and the Private Path to Policy Change > Journal of Health Politics, Policy and Law
Published: 01 June 2016
Figure 1 The Growth of Medicare Managed Care, 1985–2013. Enrollment in Medicare Managed Care as a Percent of Total Medicare Enrollment Sources : Jacobson et al. 2015 ; McGuire, Newhouse, and Sinaiko 2011 ; Lundy, Levitt, and Wang 2002 More
Journal Article

A Decade of ACOs in Medicare: Have They Delivered on Their Promise?

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Steven B. Spivack, Genevra F. Murray, Valerie A. Lewis
J Health Polit Policy Law (2023) 48 (1): 63–92.
DOI: https://doi.org/10.1215/03616878-10171090
Published: 01 February 2023
... a Medicare ACO program. In the decade since their launch, ACOs have grown into one of Medicare's flagship payment reform programs, with millions of beneficiaries receiving care from hundreds of ACOs. While great expectations surrounded ACOs' introduction into Medicare, their impacts to date have been modest...
FIGURES
View articletitled, A Decade of ACOs in <span class="search-highlight">Medicare</span>: Have They Delivered on Their Promise? View PDF for article titled, A Decade of ACOs in <span class="search-highlight">Medicare</span>: Have They Delivered on Their Promise?
Journal Article

Medicaid Use among Older Low-Income Medicare Enrollees in California and Texas: A Tale of Two States

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Jacqueline L. Angel, Ronald J. Angel, Phillip Cantu
J Health Polit Policy Law (2019) 44 (6): 885–910.
DOI: https://doi.org/10.1215/03616878-7785799
Published: 01 December 2019
...Jacqueline L. Angel; Ronald J. Angel; Phillip Cantu Abstract Context: States face increasing Medicaid expenditures largely as a result of growing dual-eligible populations. In this article we examine self-reported community-based Medicaid participation among Medicare recipients 65 and older...
FIGURES
View articletitled, Medicaid Use among Older Low-Income <span class="search-highlight">Medicare</span> Enrollees in California and Texas: A Tale of Two States View PDF for article titled, Medicaid Use among Older Low-Income <span class="search-highlight">Medicare</span> Enrollees in California and Texas: A Tale of Two States
Journal Article

Medicare at Maturity: Achievements, Lessons and Challenges

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Theodore R. Marmor
J Health Polit Policy Law (1988) 13 (1): 206–208.
DOI: https://doi.org/10.1215/03616878-13-1-206
Published: 01 February 1988
...Theodore R. Marmor Robert G. Evans and Greg L. Stoddart, Medicare at Muturity: Achievements, Lessons and Challenges (Calgary, Alberta, Canada: University of Calgary Press, 1986). Copyright © 1988 by Duke University Press 1988 206 Journal of Health Politics, Policy and Law...
View articletitled, <span class="search-highlight">Medicare</span> at Maturity: Achievements, Lessons and Challenges View PDF for article titled, <span class="search-highlight">Medicare</span> at Maturity: Achievements, Lessons and Challenges
Journal Article

Rebounding with Medicare: Reform and Counterreform in American Health Policy

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Paul Starr
J Health Polit Policy Law (2018) 43 (4): 707–730.
DOI: https://doi.org/10.1215/03616878-6527996
Published: 01 August 2018
... intervening institutional change. This dynamic has unfolded three times: from the Progressive Era to the enactment of Medicare and Medicaid in 1965, from the late 1960s to the expansion of Medicaid in the 1980s, and from defeat of the 1993 Clinton plan to the enactment of the Children's Health Insurance Plan...
View articletitled, Rebounding with <span class="search-highlight">Medicare</span>: Reform and Counterreform in American Health Policy View PDF for article titled, Rebounding with <span class="search-highlight">Medicare</span>: Reform and Counterreform in American Health Policy
Journal Article

Reversing Course on Obamacare: Why Not Another Medicare Catastrophic?

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Mark A. Peterson
J Health Polit Policy Law (2018) 43 (4): 605–650.
DOI: https://doi.org/10.1215/03616878-6527959
Published: 01 August 2018
...Mark A. Peterson Abstract Nearly three decades before the Affordable Care Act (ACA) was put on the precipice of repeal by the 2016 election of a unified Republican government, the Medicare Catastrophic Coverage Act (MCCA) was enacted with fanfare by one Congress and dismantled by the next...
FIGURES
View articletitled, Reversing Course on Obamacare: Why Not Another <span class="search-highlight">Medicare</span> Catastrophic? View PDF for article titled, Reversing Course on Obamacare: Why Not Another <span class="search-highlight">Medicare</span> Catastrophic?
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Figure 3 Public Support Minus Opposition for Medicare Catastrophic Coverage Act (MCCA), Affordable Care Act (ACA), and American Health Care Act (AHCA)/GOP Plans, Plotted at Comparable Times of Proposal, Enactment, and Repeal Effort Source: MCCA (65+), data from Himelfarb 1995; ACA KFF, data from KFF 2017; ACA Pew, data from Fingerhut 2017; AHCA Quinn, data from Quinnipiac University 2017; AHCA Huff, data from Edwards-Levy 2017

Public Support Minus Opposition for Medicare Catastrophic Coverage Act (MCC...

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in Reversing Course on Obamacare: Why Not Another Medicare Catastrophic? > Journal of Health Politics, Policy and Law
Published: 01 August 2018
Figure 3 Public Support Minus Opposition for Medicare Catastrophic Coverage Act (MCCA), Affordable Care Act (ACA), and American Health Care Act (AHCA)/GOP Plans, Plotted at Comparable Times of Proposal, Enactment, and Repeal Effort Source : MCCA (65+), data from Himelfarb 1995 ; ACA KFF, data More
Journal Article

Medicare Implementation and the Policy Process

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Judith M. Feder
J Health Polit Policy Law (1977) 2 (2): 173–189.
DOI: https://doi.org/10.1215/03616878-2-2-173
Published: 01 April 1977
...Judith M. Feder This article argues that Medicare policy toward hospitals has been profoundly influenced by the perspectives and goals its administrators acquired in a social insurance agency. The social insurance perspective meant priority to efficient claims payment over controlling the impact...
View articletitled, <span class="search-highlight">Medicare</span> Implementation and the Policy Process View PDF for article titled, <span class="search-highlight">Medicare</span> Implementation and the Policy Process
Journal Article

Medicare and Extended Care: Issues, Problems and Prospects

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Rose M. Rubin
J Health Polit Policy Law (1988) 13 (2): 384–386.
DOI: https://doi.org/10.1215/03616878-13-2-384
Published: 01 April 1988
...Rose M. Rubin Bruce C. Vladeck and Genrose J. Alfano, eds., Medicare and Extended Care: Issues, Problems and Prospects (Owings Mills, MD: National Health Publishing, 1987), 180 pp., $34.00. Copyright © 1988 by Duke University Press 1988 384 Journal of Health Politics, Policy and Law...
View articletitled, <span class="search-highlight">Medicare</span> and Extended Care: Issues, Problems and Prospects View PDF for article titled, <span class="search-highlight">Medicare</span> and Extended Care: Issues, Problems and Prospects
Journal Article

PPS Waivers: Implications for Medicare, Medicaid, and Commercial Insurers

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Stephen Zuckerman, John Holahan
J Health Polit Policy Law (1988) 13 (4): 663–681.
DOI: https://doi.org/10.1215/03616878-13-4-663
Published: 01 August 1988
...Stephen Zuckerman; John Holahan This paper compares the Medicare prospective payment system (PPS) to four all-payer rate-setting systems that operated under HCFA waiver authority. The study examines the experience of Medicare, Medicaid, and commercial insurers under the two approaches. Data from...
View articletitled, PPS Waivers: Implications for <span class="search-highlight">Medicare</span>, Medicaid, and Commercial Insurers View PDF for article titled, PPS Waivers: Implications for <span class="search-highlight">Medicare</span>, Medicaid, and Commercial Insurers
Journal Article

Medicare Policy: New Directions for Health and Long-Term Care

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Katherine Swartz
J Health Polit Policy Law (1987) 12 (1): 189–192.
DOI: https://doi.org/10.1215/03616878-12-1-189
Published: 01 February 1987
...Katherine Swartz Karen Davis and Diane Rowland, Medicare Policy: New Directions for Health and Long-Term Care (Baltimore: The Johns Hopkins University Press, 1986), 137 pp., $19.50. Copyright © 1987 by Duke University Press 1987 Book Reviews...
View articletitled, <span class="search-highlight">Medicare</span> Policy: New Directions for Health and Long-Term Care View PDF for article titled, <span class="search-highlight">Medicare</span> Policy: New Directions for Health and Long-Term Care
Journal Article

The Effect of State Regulations on the Quality and Sale of Insurance Policies to Medicare Beneficiaries

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Nelda McCall, Thomas Rice, Arden Hall
J Health Polit Policy Law (1987) 12 (1): 53–76.
DOI: https://doi.org/10.1215/03616878-12-1-53
Published: 01 February 1987
...Nelda McCall; Thomas Rice; Arden Hall This paper examines the effects of state regulations on the quality of insurance policies sold to Medicare beneficiaries and on the amount of sales abuse reported in the sale of such policies. State regulations regarding such policies relate to policy content...
View articletitled, The Effect of State Regulations on the Quality and Sale of Insurance Policies to <span class="search-highlight">Medicare</span> Beneficiaries View PDF for article titled, The Effect of State Regulations on the Quality and Sale of Insurance Policies to <span class="search-highlight">Medicare</span> Beneficiaries
Journal Article

Monitoring the Impact of the Medicare Fee Schedule on Access to Care for Vulnerable Populations

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Sally Trude, David C. Colby
J Health Polit Policy Law (1997) 22 (1): 49–71.
DOI: https://doi.org/10.1215/03616878-22-1-49
Published: 01 February 1997
...Sally Trude; David C. Colby Implementation of the Medicare Fee Schedule (MFS) introduced concerns about the potential for reduced access to care, especially for vulnerable populations. These analyses show differences in access before and after the MFS that cannot be explained by health status...
View articletitled, Monitoring the Impact of the <span class="search-highlight">Medicare</span> Fee Schedule on Access to Care for Vulnerable Populations View PDF for article titled, Monitoring the Impact of the <span class="search-highlight">Medicare</span> Fee Schedule on Access to Care for Vulnerable Populations
Journal Article

Adoption of Retrospective Medicare Maximization Billing Practices by State Medicaid Home Care Programs

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Wayne L. Anderson, Genevieve S. Kenney, Donna J. Rabiner
J Health Polit Policy Law (2003) 28 (5): 859–882.
DOI: https://doi.org/10.1215/03616878-28-5-859
Published: 01 October 2003
...Wayne L. Anderson; Genevieve S. Kenney; Donna J. Rabiner Home care services funded by Medicare and Medicaid grew rapidly throughout most of the 1990s. During this period some state Medicaid programs transferred costs for home care claims to the Medicare program to reduce their liability...
View articletitled, Adoption of Retrospective <span class="search-highlight">Medicare</span> Maximization Billing Practices by State Medicaid Home Care Programs View PDF for article titled, Adoption of Retrospective <span class="search-highlight">Medicare</span> Maximization Billing Practices by State Medicaid Home Care Programs
Journal Article

The Distributional Consequences of a Medicare Premium Support Proposal

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Thomas Rice, Katherine A. Desmond
J Health Polit Policy Law (2004) 29 (6): 1187–1226.
DOI: https://doi.org/10.1215/03616878-29-6-1187
Published: 01 December 2004
...Thomas Rice; Katherine A. Desmond This article analyzes the distributional consequences of enacting a particular premium support proposal known as Breaux-Frist I. Under the proposal, the federal government would contribute a certain amount toward the purchase of Medicare coverage, based...
View articletitled, The Distributional Consequences of a <span class="search-highlight">Medicare</span> Premium Support Proposal View PDF for article titled, The Distributional Consequences of a <span class="search-highlight">Medicare</span> Premium Support Proposal
Journal Article

The Political Life of Medicare

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Andrea Louise Campbell
J Health Polit Policy Law (2004) 29 (6): 1238–1241.
DOI: https://doi.org/10.1215/03616878-29-6-1238
Published: 01 December 2004
...Andrea Louise Campbell Jonathan Oberlander. The Political Life of Medicare. Chicago: University of Chicago Press, 2003. 288 pp. $45.00 cloth; $18.00 paper. © 2004 by Duke University Press 2004 Books...
View articletitled, The Political Life of <span class="search-highlight">Medicare</span> View PDF for article titled, The Political Life of <span class="search-highlight">Medicare</span>
Journal Article

HMO Enrollment of Medicare Recipients: An Analysis of Incentives and Barriers

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James Bautz Bonanno, Terrie Wetle
J Health Polit Policy Law (1984) 9 (1): 41–62.
DOI: https://doi.org/10.1215/03616878-9-1-41
Published: 01 February 1984
...James Bautz Bonanno; Terrie Wetle Although there has been increased interest in use of the health maintenance organization (HMO) model to resolve a variety of problems relating to provision of health care to older individuals, less than 2 percent of Medicare beneficiaries are currently enrolled...
View articletitled, HMO Enrollment of <span class="search-highlight">Medicare</span> Recipients: An Analysis of Incentives and Barriers View PDF for article titled, HMO Enrollment of <span class="search-highlight">Medicare</span> Recipients: An Analysis of Incentives and Barriers
Journal Article

Medicare Revisited: A Look Through the Past to the Future

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Robert W. Rosenblum
J Health Polit Policy Law (1985) 9 (4): 669–681.
DOI: https://doi.org/10.1215/03616878-9-4-669
Published: 01 August 1985
...Robert W. Rosenblum This paper examines the elderly's out-of-pocket health care expenditures by category of expense, before and after the inception of Medicare. It describes the shifting of out-of-pocket expenses from hospital care to nursing-home care, while physician services and drugs have...
View articletitled, <span class="search-highlight">Medicare</span> Revisited: A Look Through the Past to the Future View PDF for article titled, <span class="search-highlight">Medicare</span> Revisited: A Look Through the Past to the Future
Journal Article

How Will We Use Clinical Guidelines? The Experience of Medicare Carriers

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Colleen M. Grogan, Roger D. Feldman, John A. Nyman, Janet Shapiro
J Health Polit Policy Law (1994) 19 (1): 7–26.
DOI: https://doi.org/10.1215/03616878-19-1-7
Published: 01 February 1994
..., to link clinical guidelines to reimbursement, will likely prevail. We examine the utilization review programs of Medicare Part B carriers and the carriers' attempts to use clinical guidelines to determine medical necessity for the purpose of payment. We find that because the utilization review programs...
View articletitled, How Will We Use Clinical Guidelines? The Experience of <span class="search-highlight">Medicare</span> Carriers View PDF for article titled, How Will We Use Clinical Guidelines? The Experience of <span class="search-highlight">Medicare</span> Carriers