Adjusted community rate reforms to promote HMO participation in Medicare+Choice

Health Care Financing Review

Volumn 21, Issue 1, 1999, Pages 19-29

  Encinosa III, William E ^b   Sappington, David E M ^a  

^a UNIVERSITY OF FLORIDA   (United States)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

BOARD OF TRUSTEES; HEALTH CARE FINANCING; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; HEALTH PROGRAM; HEALTH PROMOTION; MEDICARE; PROFIT; REVIEW; RISK ASSESSMENT;

AGED; CONTRACT SERVICES; HEALTH MAINTENANCE ORGANIZATIONS; HUMANS; INCOME; MEDICARE PART C; MEDICARE PAYMENT ADVISORY COMMISSION; MODELS, ECONOMETRIC; ORGANIZATIONAL INNOVATION; RATE SETTING AND REVIEW; RISK ADJUSTMENT; RISK SHARING, FINANCIAL; UNITED STATES;

EID: 0033370518     PISSN: 01958631     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (17)

1. Falk, S.: Medicare Managed Care Plans Plot Further Exits From Certain Markets. Managed Care Reporter 5(20):474, May 19, 1999.
2. Ginsberg, P., and Gabel, J.: Tracking Health Care Costs: What's New in 1998? Health Affairs 17(5):141-146, September 1998.
3. Glass, D., and Sappington, D.: Cost Shifting Under Medicare's Financial Regulation of Managed Care Operators. Gainesville, FL University of Florida Discussion Paper. May 1999.
4. Health Care Financing Administration: Medicare Managed Care Market Penetration for All Medicare Plan Contractors. Internet address: http://www.hcfa.gov/medicare/mpsct1htm. May 1999.
5. Managed Care Outlook: HMO Industry Suffers First Collective Loss. Managed Care Outlook 11(34):1, September 4, 1998.
6. Medicare Payment Advisory Commission: Report to the Congress: Medicare Payment Policy. Washington, DC. March 1998.
7. Medicare Payment Advisory Commission: Report to the Congress: Medicare Payment Policy. Washington, DC. March 1999.
8. Medicine and Health: New Industry Talk of Rough Going for Medicare+Choice. Medicine and Health 53(20):1, May 17, 1999.
9. National Health Policy Forum: Medicare HMO Pullouts. Issue Brief No. 730. Washington, DC. George Washington University, 1999.
10. Office of Inspector General, U.S. Department of Health and Human Services: Administrative Costs Submitted by Risk-Based HMOs on the Adjusted Community Rate Proposal are Highly Inflated. Audit Report A-14-97-00202. Washington, DC. July 1998.
11. Phillips, C.: The Regulation of Public Utilities. Arlington, VA. Public Utilities Reports, Inc. 1993.
12. Physician Payment Review Commission: PPRC Annual Report to Congress, 1997. Washington, DC. 1997.
13. Rodgers, J.: Congress Expands Medicare Plan Choices: What Does It Mean for Providers and Plans? Price Waterhouse Health Policy Economics Series Paper #2. 1998.
14. Smith, S., Freeland, M., Heffler, S., et al.: The Next Ten Years of Health Spending: What Does the Future Hold? Health Affairs 17(5):128-140, September 1998.
15. United States Code of Federal Regulation: Federal Register 63:123. June 26, 1998.
16. U.S. General Accounting Office: Many HMOs Experience High Rates of Beneficiary Disenrollment. GAO/HEHS-98-142. Washington, DC. April 1998.
17. U.S. General Accounting Office: Medicare Managed Care Plans: Many Factors Contribute to Recent Withdrawals. GAO/HEHS-99-91. Washington, DC. April 1999.