Social and Behavioral Sciences Commons^™

The Continuing Cost Of Privatization: Extra Payments To Medicare Advantage Plans In 2008, Brian Biles, Emily Adrion, Stuart Guterman

Health Policy and Management Faculty Publications

The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, every MA plan in the nation is paid more for its enrollees than they would have been expected to cost in traditional fee-for-service Medicare. The authors calculate that payments to MA plans in 2008 will be 12.4 percent greater than the corresponding costs in traditional Medicare—an average increase of $986 per MA plan enrollee, for a total of more than $8.5 billion. Over the five-year period 2004–2008, extra payments to MA plans are estimated to have totaled nearly $33 billion. Although …

Primer On Medicare Advantage Payments In 2008, Brian Biles, Emily Adrion

Health Policy and Management Faculty Publications

The Medicare Modernization Act of 2003 (MMA) included provision intended to increase the role of private health plans in Medicare. These provisions, building on policies adopted earlier in 1997 and 2000, set Medicare Advantage (MA) plan benchmark rates at levels higher than average costs in tradition free-for-service Medicare in every county in the nation. The total amount of extra payments to Medicare Advantage plans resulting from these policies total over $8.5 billion in 2008 and over $82 billion over the five year period between 2009 and 2013.

This briefing paper outlines the three major Medicare policies that generate these extra …

Costs And Benefits Of Elderly Prescription Drug Coverage: Evidence From Veterans’ Health Care, Melissa Boyle

Economics Department Working Papers

This study tests the impact of a public prescription benefit on Medicare-eligible veterans, utilizing a mid-1990s benefit change in the VA health care system. Using data from the Medicare Current Beneficiary Survey, I compare prescription spending and utilization, as well as use of other health services and health outcomes for veterans and non-veterans before and after the VA insurance change. Results show that receipt of a publicly-provided prescription benefit leads to an increase in spending on prescriptions, and simultaneously, a decrease in spending on other medical services. On average, every $1 increase in drug spending is associated with a $6.50 …

The Centers For Medicare And Medicaid Services’ Approach To Value-Based Purchasing, Bettina Berman

Value-Based Purchasing Newsletter

Although evidence suggests that both the quality and the affordability of health care can be improved¹, it is likely that such improvements will come at great cost. Healthcare expenditures in the United States (U.S.) are expected to rise precipitously - from $1.5 trillion in 2005 to over $4 trillion in 2016.² Medicare, the nation’s single largest health care purchaser, spent an estimated $425 billion on health services in 2007. With the projected growth in Medicare beneficiaries, the amount may surpass $800 billion by 2017, placing the government under significant pressure to control health care costs.³

This …

Uncle Sam's Debut On The Value-Based Purchasing Stage, Neil I. Goldfarb

Value-Based Purchasing Newsletter

No abstract provided.

Political Economy, Moral Economy And The Medicare Modernization Act Of 2003, Judie Svihula

The Journal of Sociology & Social Welfare

Through the lens of political and moral economy, I examined the dominant values and actors in the legislative process of the Medicare Modernization Act of 2003. In my content analysis of federal hearings, I found that witnesses from government agencies, Congress and think tanks had almost equal presence at the hearings. Witnesses who were invited by Congress to testify at the hearings expressed twice as much support for private interests than for the general Medicare population or low-income beneficiaries. Few expressed concern for the uninsured population. Witnesses offered almost four times as many expressions of support for market rationalism than …

Tracing The History Of Medicare Home Health Care: The Impact Of Policy On Benefit Use, Joan K. Davitt, Sunha Choi

The Journal of Sociology & Social Welfare

We trace key policy changes that affected use of the Medicare home health benefit from the 1980s through the prospective payment system implemented in 2000, analyzing the impact on three measures of home care use: expenditures, users and visits. We demonstrate the impact of policies generated in the legislative, the judicial, and the executive branches of government and the gaming behavior of home health agencies in response to policy changes. Our analysis suggests that the policy itself and the implementation process are critical to understanding benefit use. The incentives in the policies and agency reactions had the potential to generate …

Health Insurance And The Labor Supply Decisions Of Older Workers: Evidence From The U.S. Department Of Veterans Affairs, Melissa Boyle, Joanna N. Lahey

Economics Department Working Papers

This paper exploits a major mid-1990s expansion in the U.S. Department of Veterans Affairs health care system to provide evidence on the labor market effects of expanding health insurance availability. Using data from the Current Population Survey, we compare the labor market behavior of older veterans and non-veterans before and after the VA health benefits expansion to test the impact of public health insurance on labor supply. We find that older workers are significantly more likely to decrease work both on the extensive and intensive margins after receiving access to non-employer based insurance. Older workers are also more likely to …