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Medicare Competitive Pricing: Lessons Being Learned In Phoenix And Kansas City, Nora Super
Medicare Competitive Pricing: Lessons Being Learned In Phoenix And Kansas City, Nora Super
National Health Policy Forum
Written as policymakers scrutinized two Medicare competitive bidding demonstration projects set to take place in Phoenix and Kansas City, this issue brief analyzes two demonstration projects designed to test whether Medicare could pay health plans in a competitive manner. The brief reviews decisions made by the Competitive Pricing Advisory Commission (CPAC), including design considerations such as plan eligibility and participation, the standard benefit package, the bidding process, and the government contribution to premiums. It also looks at the reasons for opposition to the project and the relationship of this demonstration to broader efforts to reform the Medicare program.
The Public Stake In Biomedical Research: A Policy Perspective, Karen Matherlee
The Public Stake In Biomedical Research: A Policy Perspective, Karen Matherlee
National Health Policy Forum
An introduction to a Forum series on biomedical research policy issues, this paper provides background on the organization and structure of both public and private research entities. It outlines the federal components, from the National Institutes of Health (NIH) to the Department of Veterans Affairs. It also looks at the rapid growth in pharmaceutical, biotechnology, and medical device research and development and the varying responses from managed care plans, practice-based research networks, and contract research organizations. After laying out various tensions in the field, such as competition among disease-oriented advocates, alignment of different priorities, allocation of dollars between basic and …
An Analysis Of Implementation Issues Relating To Chip Cost-Sharing Provisions For Certain Targeted Low Income Children, Sara J. Rosenbaum, Anne Rossier Markus, Dylan Roby
An Analysis Of Implementation Issues Relating To Chip Cost-Sharing Provisions For Certain Targeted Low Income Children, Sara J. Rosenbaum, Anne Rossier Markus, Dylan Roby
Health Policy and Management Issue Briefs
This analysis, prepared for the Health Care Financing Administration and the Health Resources and Services Administration, examines issues that arise under laws designed to avert excessive cost-sharing in the case of low income families whose children participate in the State Children’s Health Insurance Program (CHIP). High cost-sharing has been shown to significantly affect children’s participation in insurance programs, as well as their utilization of health services. As a result, the Federal CHIP legislation, while permitting cost-sharing under certain circumstances, also places limitations on the total amount of cost-sharing to which families can be exposed for services covered by State CHIP …