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1. Share of Cost, Medicare Doesn’t Work As Well For Younger, Disabled Beneficiaries As It Does For Older Enrollees [Web First] Medicare is not working as well for its eight million disabled beneficiaries under age sixty-five as it is for its older beneficiaries. We report on a 2008 survey that found significant differences between the two Medicare populations, with the younger group experiencing more problems of cost and access. Even with the Medicare Part D prescription […]...
2. Analysis of Medicare Advantage HMOs Compared With Traditional Medicare Shows Lower Use of Many Services Analysis of Medicare Advantage HMOs Compared With Traditional Medicare Shows Lower Use of Many Services ...
3. Medicare Postacute Care Payment Reforms Have Potential to Improve Efficiency of Care, But May Need Changes to Cut Costs The Affordable Care Act mandates changes in payment policies for Medicare postacute care services intended to contain spending in the long run and help ensure the program’s financial sustainability. In addition to reducing annual payment increases to providers under the existing prospective payment systems, the act calls for demonstration projects of bundled payment, accountable care […]...
4. Building Regulatory And Operational Flexibility Into Accountable Care Organizations And ‘Shared Savings’ The Affordable Care Act created accountable care organizations (ACOs), which will be a new part of Medicare as of January 2012, together with a “shared savings program” that will modify how these organizations will be paid to care for patients. Accountable care organizations have the potential to lower costs, improve the quality of care, facilitate delivery […]...
5. Share of Cost, Health Care, Medicare and Health Insurance Fraud Share of Cost, Health Care, Medicare and Health Insurance Fraud...
6. Long Term Care Share of Cost Providers receiving an eligibility verification message (see following example) that indicates a subscriber has an LTC SOC should not  clear the SOC online.  Subscribers with aid codes 13, 23, 53 and 63 must have their LTC SOC cleared on the claim.  The LTC facility  includes the LTC SOC amount for Medi-Cal-covered services on the  Payment […]...
7. Driving Population Health Through Accountable Care Organizations Driving Population Health Through Accountable Care Organizations...
8. Share of Cost, Additional Reductions In Medicare Spending Growth Will Likely Require Shifting Costs To Beneficiaries Share of Cost, Additional Reductions In Medicare Spending Growth Will Likely Require Shifting Costs To Beneficiaries ...
9. Share of Cost, Supplemental Coverage Associated With More Rapid Spending Growth For Medicare Beneficiarie Share of Cost, Supplemental Coverage Associated With More Rapid Spending Growth For Medicare Beneficiarie...
10. How The Center For Medicare And Medicaid Innovation Should Test Accountable Care Organizations [Payment & Delivery] The Patient Protection and Affordable Care Act establishes a national voluntary program for accountable care organizations (ACOs) by January 2012 under the auspices of the Centers for Medicare and Medicaid Services (CMS). The act also creates a Center for Medicare and Medicaid Innovation in the CMS. We propose that the CMS allow flexibility and tiers […]...
11. As Roughly 700,000 Prisoners Are Released Annually, About Half Will Gain Health Coverage And Care Under Federal Laws During 2009, 730,000 prisoners were released from federal and state prisons.  This is a 21 percent increase from the number of prisoners released in 2000. Poor health and poor health coverage have been major challenges for former prisoners trying to reintegrate into the community and find work. Discuss  are the challenges and the likely effect of […]...
12. Share of Cost, Innovations At Miami Practice Show Promise For Treating High-Risk Medicare Patients Share of Cost, Innovations At Miami Practice Show Promise For Treating High-Risk Medicare Patients ...
13. Federal Agencies Should Take Advantage Of Opportunities To Promote Integration Of Primary Care And Public Health Federal Agencies Should Take Advantage Of Opportunities To Promote Integration Of Primary Care And Public Health...
14. Share of Cost, If Slow Rate Of Health Care Spending Growth Persists, Projections May Be Off By $770 Billion Share of Cost, If Slow Rate Of Health Care Spending Growth Persists, Projections May Be Off By $770 Billion ...
15. Several Medicare Cost Changes for New Beneficiaries in the President’s Budget Proposal Several Medicare Cost Changes for New Beneficiaries in the President’s Budget Proposal...