Abstract
The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 expands the role of private health plans in Medicare through prescription drug plans and a revised Medicare+Choice (M+C), renamed Medicare Advantage, program. This paper discusses the factors responsible for the failure of M+C to develop as intended in 1997 and analyzes the challenges for MMA implementation in light of these factors. They include making a complex program understandable to beneficiaries; addressing plans' efforts to avoid enrolling high-cost beneficiaries; ensuring stability of benefits, providers, and plans; dealing with beneficiaries enrolled in unsuitable plans; providing equity of health benefits throughout the country; and controlling overall Medicare costs.
| Original language | English (US) |
|---|---|
| Journal | Health Affairs |
| Volume | 23 |
| Issue number | SUPPL. 2 |
| DOIs | |
| State | Published - Jul 2004 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Nursing(all)
- Health(social science)
- Health Professions(all)
- Health Policy
Cite this
Medicare advantage : Déjà Vu all over again? / Biles, Brian; Dallek, Geraldine; Nicholas, Lauren.
In: Health Affairs, Vol. 23, No. SUPPL. 2, 07.2004.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Medicare advantage
T2 - Déjà Vu all over again?
AU - Biles, Brian
AU - Dallek, Geraldine
AU - Nicholas, Lauren
PY - 2004/7
Y1 - 2004/7
N2 - The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 expands the role of private health plans in Medicare through prescription drug plans and a revised Medicare+Choice (M+C), renamed Medicare Advantage, program. This paper discusses the factors responsible for the failure of M+C to develop as intended in 1997 and analyzes the challenges for MMA implementation in light of these factors. They include making a complex program understandable to beneficiaries; addressing plans' efforts to avoid enrolling high-cost beneficiaries; ensuring stability of benefits, providers, and plans; dealing with beneficiaries enrolled in unsuitable plans; providing equity of health benefits throughout the country; and controlling overall Medicare costs.
AB - The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 expands the role of private health plans in Medicare through prescription drug plans and a revised Medicare+Choice (M+C), renamed Medicare Advantage, program. This paper discusses the factors responsible for the failure of M+C to develop as intended in 1997 and analyzes the challenges for MMA implementation in light of these factors. They include making a complex program understandable to beneficiaries; addressing plans' efforts to avoid enrolling high-cost beneficiaries; ensuring stability of benefits, providers, and plans; dealing with beneficiaries enrolled in unsuitable plans; providing equity of health benefits throughout the country; and controlling overall Medicare costs.
UR - http://www.scopus.com/inward/record.url?scp=17144369227&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=17144369227&partnerID=8YFLogxK
U2 - 10.1377/hlthaff.W4.586
DO - 10.1377/hlthaff.W4.586
M3 - Article
C2 - 15601665
AN - SCOPUS:17144369227
VL - 23
JO - Health Affairs
JF - Health Affairs
SN - 0278-2715
IS - SUPPL. 2
ER -