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Full-Text Articles in Health Policy
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 …
Paying Medicare Private Plans By Competitive Bidding: Not The Same As Costs In Regular Medicare, Brian Biles, Jonah Pozen
Paying Medicare Private Plans By Competitive Bidding: Not The Same As Costs In Regular Medicare, Brian Biles, Jonah Pozen
Health Policy and Management Faculty Publications
Medicare Advantage plans are now paid $11 billion a year, and $150 billion over 10 years, more than costs in regular fee-for-service (FFS) Medicare. In the past two years there have been discussions about reducing MA payments to the level of 100 percent of average costs in FFS and using the savings to offset the costs of new Federal health initiatives such as health care reform. Earlier this year, OMB proposed "reducing Medicare overpayments to private insurers through competitive payments." Under this proposal, MA plan "payments would be based on an average of plans' bids submitted to Medicare." This issue …
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.
Policy Issues Affecting Maine’S Hospitals, John A. Gale Ms, Jennifer D. Lenardson Mhs
Policy Issues Affecting Maine’S Hospitals, John A. Gale Ms, Jennifer D. Lenardson Mhs
Rural Hospitals (Flex Program)
Legislators and other policymakers will be continually challenged to balance the needs of hospitals for appropriate reimbursement and oversight with supporting their provision of important services to local communities.