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Full-Text Articles in Health Policy
Medicare Advantage Payment Provisions: Health Care And Education Affordability Reconciliation Act Of 2010 H.R. 4872, Brian Biles, Grace Arnold
Medicare Advantage Payment Provisions: Health Care And Education Affordability Reconciliation Act Of 2010 H.R. 4872, Brian Biles, Grace Arnold
Health Policy and Management Issue Briefs
The Health Care and Education Affordability Reconciliation Act of 2010 would make major changes to Medicare Advantage (MA) payment policies. Overall, payments to MA plans would be reduced from the current national average of 113 percent of local fee-for-service (FFS) costs to a new average of 101 percent of FFS costs. The Congressional Budget Office (CBO) has estimated that the new polices would reduce Medicare spending by $132 billion over 10 years. The new policies would set county payment benchmarks for MA plans at 115 percent, 107.5 percent, 100 percent, and 95 percent of local FFS costs depending of the …
Paying Medicare Advantage Plans By A Blend-Based System: Where Are The Gains And Losses?, Brian Biles, Jonah Pozen, Grace Arnold
Paying Medicare Advantage Plans By A Blend-Based System: Where Are The Gains And Losses?, Brian Biles, Jonah Pozen, Grace Arnold
Health Policy and Management Issue Briefs
Medicare Advantage (MA) plans are now paid $11 billion a year and $150 billion over 10 years more than costs in fee-for-service (FFS) Medicare. In the past two years there have been discussions about reducing MA payments to the level of FFS costs and using the savings to offset the costs of new Federal initiatives such as health care reform. These discussions have included a number of options on the specific new approach to pay plans including: average FFS costs in each county; a blend of local county FFS costs and national FFS average costs; and a regional system based …
The Application Of The Emergency Medical Treatment And Labor Act (Emtala) To Hospital Inpatients, Lara Cartwright-Smith, Sara J. Rosenbaum, Karen Belli, Elaine Purcell, Tasmeen S. Weik
The Application Of The Emergency Medical Treatment And Labor Act (Emtala) To Hospital Inpatients, Lara Cartwright-Smith, Sara J. Rosenbaum, Karen Belli, Elaine Purcell, Tasmeen S. Weik
Health Policy and Management Issue Briefs
This issue brief provides a brief overview of the Emergency Medical Treatment and Labor Act (EMTALA) and focuses on its application to hospital inpatients. EMTALA applies differently to patients than non-patients, and also applies differently to patients admitted through the emergency department than patients admitted as regular inpatients. In addition, courts and the Centers for Medicare and Medicaid Services (CMS) have differed in their interpretation of the statute. Depending on the specific facts of any particular case, EMTALA may or may not have implications for specialty-related transfers and discharges.
Medicare, Managed Care, And Behavioral Health Care, Sara J. Rosenbaum, Barbara Markham Smith
Medicare, Managed Care, And Behavioral Health Care, Sara J. Rosenbaum, Barbara Markham Smith
Health Policy and Management Issue Briefs
This issue brief examines Medicare and managed care for Medicare beneficiaries with behavioral health needs. Although only a relatively small proportion of Medicare beneficiaries are enrolled in managed care arrangements at the present time, proposals to expand the use of Medicare managed care can be expected to receive a good deal of attention in the coming years as part of a larger debate over Medicare's long term future. Thus, this issue brief examines the Medicare+Choice (M+C) program from the perspective of Medicare beneficiaries with mental illness and addiction disorders.