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Managed Care
July 2000
Michael Levin-Epstein
Congress Asked To Take Action As HMOs Flee Managed Medicare Thanks mainly to the increasing cost of providing a prescription drug benefit, HMOs are exiting Medicare+Choice, the system that was supposed to manage the health of the nation's senior citizens, in droves. Only an act of Congress can save Medicare+Choice, but is seems doubtful that will happen. mark for My Articles similar articles
Managed Care
April 2002
Frank Diamond
Medicare+Choice: Uncertain Future for Unstable Program While policy makers haggle over President Bush's budget request for the system, an ominous question looms: Can money solve all the problems? mark for My Articles similar articles
Managed Care
October 2001
Michael Levin-Epstein
Medicare+Choice Reform: Hope, but No Quick Action Expected There have been small accomplishments, and wheels have been churning for more forceful action -- that is, they were until Sept. 11... mark for My Articles similar articles
Managed Care
May 2007
Frank Diamond
Medicare Advantage Hits Jackpot with Private Fee-for-Service Plans The secret to the success of Medicare private fee-for-service plans is as old as gold. Will beneficiary satisfaction force Congress to keep the faucet turned on? mark for My Articles similar articles
Managed Care
November 2001
Medicare+Choice Problems Chasing Away 58 Health Plans Medicare+Choice, the program that was supposed to ease the elderly into managed care, is itself suffering from the uneasiness of HMOs dissatisfied with payment rates... mark for My Articles similar articles
Managed Care
January 2001
David Ricks & Joe Suminski
Nowhere To Go but Out? Tracking Medicare+Choice Managed Medicare's trouble may have something to do with underfunding or rich benefits, but for health plans, market share has a lot to do with it, too... mark for My Articles similar articles
Managed Care
March 2007
John Carroll
Democratic Agenda Places Medicare Advantage at Risk Battle lines are drawn over proposals to raid the Medicare managed care program of funds to be applied to other health care needs. Democrats themselves are split. mark for My Articles similar articles
Managed Care
April 2002
John A. Marcille
Nobody Wants M+C To Die, So Why Can't We Make It Work? Money alone can't solve all of Medicare+Choice's woes, and structural problems will need to be addressed... mark for My Articles similar articles
Knowledge@Wharton Prescription Drug Coverage for Seniors Faces Uncertain Future The discussion about adding a prescription drug benefit to Medicare will be put on hold... mark for My Articles similar articles
Financial Planning
April 1, 2010
Donald Jay Korn
Medicare: Change is Coming This is a great time to get together with clients over 65 who will be affected by health care changes and go over their Medicare coverage. At the same time, you can see what other areas of financial planning are on their mind. mark for My Articles similar articles
Managed Care
October 2002
Though M+C Erosion Slows, Reimbursement Still an Issue The exodus of health plans from Medicare+Choice will moderate somewhat next year, offering hope that the struggling system can make a comeback. mark for My Articles similar articles
Managed Care
March 2002
How Medicare beneficiaries spend money on drugs The Kaiser Family Foundation notes that Medicare beneficiaries account for 14 percent of the U.S. population, but for 43 percent of the nation's spending on prescription drugs. Thirteen percent of beneficiaries had to pay $2,000 or more out of pocket in 2001... mark for My Articles similar articles
Managed Care
March 2002
M+C Enrollees Bound to Their Choice Until June A lock-in mechanism for Medicare+Choice that kicked in Jan. 1 narrows the period during which enrollees can switch from health plan to health plan... mark for My Articles similar articles
Managed Care
February 2001
In Medicare Bill, HMOs Got What They Wanted When the dust cleared over how $35 billion in Medicare "givebacks" would be divided, the Republicans prevailed -- Medicare HMOs got a bigger cut than Democrats wanted to give them. Now, President Bush may be poised to give Medicare managed care plans more... mark for My Articles similar articles
Financial Planning
November 1, 2007
Donald Jay Korn
Medicare Choices What are Medicare private fee-for-service plans and why did their fortunes rise and fall so dramatically? Most important, if these plans survive in their current form, should advisors suggest them for clients enrolled in or approaching Medicare eligibility? mark for My Articles similar articles
Managed Care
May 2000
Prescription Drug Benefit Gaining In Election Year Considered a dead issue just weeks ago, a prescription drug benefit in Medicare is suddenly thought to be the health care issue with the best chance for passage this year.... mark for My Articles similar articles
Managed Care
March 2002
Michael Levin-Epstein
Illinois's Medicare Drug Program Called 1st Stab at National Reform The Illinois demonstration program gives the state permission to use federal and state Medicaid dollars to provide prescription drug coverage for 365,000 low-income, elderly Medicare beneficiaries... mark for My Articles similar articles
Knowledge@Wharton
July 30, 2003
Restructuring Medicare Is a Riskier Operation than First Thought Hailed as a bipartisan success when passed in late June, two Medicare reform bills are losing some of their luster as they face closer scrutiny by a conference committee made up of members of both chambers charged with reconciling the legislation this fall. mark for My Articles similar articles
Managed Care
February 2004
John A. Marcille
The Administration Delivers A Major Gift to Managed Care Which brings me to the announcement that Medicare payments to health plans participating in what was called Medicare+Choice but is now known as MedicareAdvantage will increase by a record 10.6 percent. mark for My Articles similar articles
Managed Care
April 2005
Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation. mark for My Articles similar articles
Managed Care
August 2000
Medicare+Choice pullouts' deep, deep sting The health plan exodus from Medicare+Choice will affect 934,000 people in 2001 -- more than were affected in 1999 and 2000 combined, according to the Health Care Financing Administration. mark for My Articles similar articles
Managed Care
January 2004
John Carroll
Do the Medicare Math, Then Make Quick Decision Congress frees up billions for plans that choose to participate in a new program for enrollees. This may be opportunity knocking. mark for My Articles similar articles
Managed Care
March 2001
Bush: Medicare Drug Benefit Tied To Overall Reform Working quickly, President Bush has drafted the first half of his prescription drug plan for Medicare and sent it to Congress... mark for My Articles similar articles
Managed Care
May 2001
Michael Levin-Epstein
Prescription Drug Talk Cooled Off Faster Than a Texas Thunderstorm Medicare reform -- and especially prescription drug benefits within Medicare -- no longer appears to be the burning issue it once was on Capitol Hill. The culprits: priorities and money... mark for My Articles similar articles
Managed Care
May 2000
Michael Levin-Epstein
Marketing Medicare+Choice? Mind Your Ps and Qs, Says OIG A lot of Medicare HMOs' marketing materials don't cut it, says a report by the Office of the Inspector General. It adds that the Health Care Financing Administration is partly to blame.... mark for My Articles similar articles
Managed Care
July 2007
AMA: Patients Will Feel Cuts in Medicare Next year's proposed 10 percent cut in Medicare payments is serving as a rallying point for members of the American Medical Association, which says the cuts will make it difficult for physicians to accept new Medicare patients. mark for My Articles similar articles
Managed Care
November 1999
Medicare Reform Dead for Now On Capitol Hill mark for My Articles similar articles
Searcher
October 2011
Stephanie C. Ardito
The Medical Digital: Navigating the Medicare Maze Since entitlement programs are the chief governmental programs under fire, I decided to revisit the healthcare bills passed back in March (H.R. 3590, the Patient Protection & Affordable Care Act). mark for My Articles similar articles
Managed Care
February 2007
Medicare Part D Cost Increase Estimate Lowered Net Medicare Part D costs for fiscal year 2008 are estimated to be 30 percent less than projected when the benefit was created back in 2003. mark for My Articles similar articles
Managed Care
February 2006
For Drugs, the VA Pays Far Less Than Medicare A recent survey indicates that prices for the top 20 drugs used by Medicare enrollees are much higher than prices negotiated by the Department of Veterans Affairs. mark for My Articles similar articles
Managed Care
September 2007
John Carroll
Who Gets Covered, Junior or Grandma? America's Health Insurance Plans is mounting a very public campaign aimed at portraying a House bill as a measure that robs enrollees of essential benefits. mark for My Articles similar articles
Managed Care
March 2008
CMS Hybrid Payment System Shows Promise Combining Medicare fee-for-service payments with new incentive programs could help physician groups save money for Medicare and reach quality-of-care targets. mark for My Articles similar articles
Managed Care
February 2005
Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players. mark for My Articles similar articles
Managed Care
May 2003
Premiums up, benefits down for M+C Premiums continue to rise for Medicare+Choice beneficiaries while the benefit selection gets somewhat narrower, a study funded by the Commonwealth Fund and conducted by Mathematica Policy Research finds. Monthly premiums rose from about $23 in 2001 to about $37 in 2003. mark for My Articles similar articles
Managed Care
February 2004
John Carroll
New Medicare Risk Adjustments Bad News for Unprepared HMOs Getting less-than-hale elderly enrolled can finally be a sound business strategy for HMOs that comprehend the new rules and have sufficient IT capability. mark for My Articles similar articles
Managed Care
November 2004
Frank Diamond
DM's Cost-Effectiveness Doubted in CBO Report Congress's financial review agency says that not enough evidence exists to prove that disease management saves money. Many beg to differ. mark for My Articles similar articles
Managed Care
June 2002
John Carroll
DM and Medicare: A Marriage Made in Heaven? With a budget of about $230 billion for 40 million patients, many with chronic ailments, is it any wonder that disease management and Medicare are courting? mark for My Articles similar articles
Pharmaceutical Executive
May 1, 2006
Huang, Pesile & Mozeson
Medicare Part D: D for Doomed? New drug coverage plans cost more money and serve fewer patients than the government expected. What if things get worse? Here are two scenarios for disaster. mark for My Articles similar articles
Registered Rep.
October 13, 2011
Mark Miller
Determining Your Elderly Clients' Best-Fit in Medicare Plans You may be able to help senior clients save thousands of dollars in out-of-pocket health care costs by encouraging them to comparison shop for Medicare prescription drug and managed care options during the program's annual fall enrollment season. mark for My Articles similar articles
Managed Care
September 2003
Medicare+Choice expenses increasing for enrollees Those who argue that Medicare and managed care don't mix well have new data to take to the fight. A Commonwealth Fund report states that the average out-of-pocket costs for Medicare+Choice enrollees soared 10 percent this year. mark for My Articles similar articles
Managed Care
March 2006
Financial Picture Looking Better For Part D News about financing the massive Medicare Part D program is good these days - or at least better. mark for My Articles similar articles
Managed Care
September 2004
Bush Officials Seek Bounce From Medicare Reform Law Unfortunately for Bush, a recent survey says that most Medicare recipients who plan to let this issue influence their vote plan to cast those votes for Sen. John Kerry. mark for My Articles similar articles
Managed Care
September 2006
John Carroll
Managed Medicare Revitalized: Feel-Good Plan of the Decade Insurers are largely happy with what they've seen. They're creating new benefit packages and expect more business in the next one to three years. mark for My Articles similar articles
Managed Care
July 2002
Memo Clarifies CMS Guidelines on Injectables Injectable drugs should be covered by Medicare if beneficiaries administer them less than 50 percent of the time, according to a clarification on this issue by the Centers for Medicare and Medicaid services that's set to take effect Aug. 1. mark for My Articles similar articles
Managed Care
September 2000
Any way you cut it, employers appear to save if Medicare adopts drug benefit A new analysis suggests that a prescription drug benefit in Medicare would reduce employer expense for health coverage--which, in turn, could encourage more employers to offer some form of drug coverage and thus reverse this erosion... mark for My Articles similar articles
Managed Care
December 2002
Drug-discount program's effectiveness hindered by lack of use California offers a prescription drug discount program that allows Medicare beneficiaries to get discounts just by showing their Medicare cards to pharmacists. Unfortunately, a majority of those eligible -- both those with and without drug coverage -- have never heard of the program. mark for My Articles similar articles
Managed Care
May 2005
Medicare PPOs Face Challenge to Funding All the excitement in the industry about Medicare PPOs died in a hurry last month as the Medicare Payment Advisory Committee (MedPAC) moved closer to recommending that the $10 billion fund for the program be eliminated. mark for My Articles similar articles
Managed Care
February 2002
Nutrition Help Now Covered By Medicare In a move that may eventually influence benefits packages offered by private insurers, Medicare this year expanded preventive services to include nutrition therapy and pain management for some patients... mark for My Articles similar articles
The Motley Fool
January 22, 2007
Dan Caplinger
Understanding Medicare: Claims In general, Medicare provides a level of coverage that is fairly similar to what private health insurance plans offer. Here are some tips for getting the most from it. mark for My Articles similar articles
Managed Care
September 2005
John Carroll
DM Industry Confident It Can Hit Medicare Goals Though there are challenges to serving the elderly, the movers and shakers of disease management say that they should be able to cut costs in pilot populations by 5%. mark for My Articles similar articles