Who really wants price competition in medicare managed care?

Health Affairs

Volumn 19, Issue 5, 2000, Pages 30-43

  Nichols, Len M ^a   Reischauer, Robert D ^a  

^a URBAN INSTITUTE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

BUDGET; CONSUMER; FEASIBILITY STUDY; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH SERVICES RESEARCH; HUMAN; MEDICARE; ORGANIZATION AND MANAGEMENT; POLITICS; PROSPECTIVE PAYMENT; REVIEW; UNITED STATES;

BUDGETS; COMPETITIVE MEDICAL PLANS; CONSUMER PARTICIPATION; EFFICIENCY, ORGANIZATIONAL; FEASIBILITY STUDIES; HEALTH CARE REFORM; HEALTH SERVICES RESEARCH; HUMANS; MANAGED COMPETITION; MEDICARE PART C; POLITICS; PROSPECTIVE PAYMENT SYSTEM; UNITED STATES;

EID: 0034263845     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.19.5.30     Document Type: Article

References (11)

1. The payment formula is described in detail in Medicare Payment Advisory Commission, Annual Report to Congress (Washington: MedPAC, March 1999).
2. Ibid.
3. Plans are not allowed to earn abnormal profits on their Medicare business, and so if the capitated payments far exceed their costs, they must rebate the excess to the Treasury or use the money to provide additional benefits.
4. The members of the committee and their affiliations are listed in B. Dowd, R. Coulam, and R. Feldman, "Medicare Reform and Competitive Pricing," Health Affairs (Sep/Oct 2000): Note 15.
5. Agendas and minutes of each CPAC meeting are available at www.hcfa.gov/medicare/cpacpage.htm.
6. "Report to the Secretary of the Department of Health and Human Services from the Competitive Pricing Advisory Committee" (31 March 1999). This report contains much detail, supporting material, and references.
7. Actually, the BBA called for risk adjustment starting in 1999, but HCFA could not implement it so soon.
8. The president's Medicare reform proposal may be found at http://w3.access.gpo.gov/usbudget/fy2001/pdf/budget.pdf, and the bipartisan commission's proposal may be found at medicare.commission.gov/medicare/index.html.
9. "Medicare Competitive Pricing: Lessons Being Learned in Phoenix and Kansas City," National Health Policy Forum Issue Brief no. 750, available at www.nhpf.org/ibs.htm; and M. Weinstein, "Economic Scene," New York Times, 23 September 1999, C2.
10. "Medicare Competitive Pricing: Lessons Being Learned in Phoenix and Kansas City," National Health Policy Forum Issue Brief no. 750, available at www.nhpf.org/ibs.htm; and M. Weinstein, "Economic Scene," New York Times, 23 September 1999, C2.
11. The competitive acquisition of items and services demonstration did not run into this problem because it offered a benefit-lower copayments.