Improving the Medicare Market: Adding Choice and Protections / Edition 1 by Stanley B. Jones, Marion Ein Lewin, Committee on Choice and Managed Care: Assuring Public Accountability and Information for Informed Purchasing by, Institute of Medicine | | 9780309055352 | Hardcover | Barnes & Noble
Improving the Medicare Market: Adding Choice and Protections / Edition 1

Improving the Medicare Market: Adding Choice and Protections / Edition 1

by Stanley B. Jones, Marion Ein Lewin, Committee on Choice and Managed Care: Assuring Public Accountability and Information for Informed Purchasing by, Institute of Medicine
     
 

ISBN-10: 0309055350

ISBN-13: 9780309055352

Pub. Date: 11/04/1996

Publisher: National Academies Press

Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress.

However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market

Overview

Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress.

However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sector—yet protect them as consumers and patients.

This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed care—how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters.

The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.

Product Details

ISBN-13:
9780309055352
Publisher:
National Academies Press
Publication date:
11/04/1996
Edition description:
New Edition
Pages:
384
Product dimensions:
6.00(w) x 9.00(h) x 1.19(d)

Table of Contents

EXECUTIVE SUMMARY 1(10)
1 OVERVIEW
11(28)
The Medicare Program
11(2)
Medicare Managed Care
13(8)
Restructuring Medicare and the Context for the IOM Study
21(2)
How Is the Medicare Market Different?
23(5)
The Committee's Charge
28(1)
Definitions and Study Approach
29(10)
2 SYMPOSIUM SUMMARY
39(41)
Structuring Accountability for Medicare: Looking at a Continuum of Options
39(7)
Structuring Choice: A Look at Model Programs
46(4)
Are Medicare Beneficiaries Different?
50(6)
What Information Do Medicare Beneficiaries Want and Need?
56(7)
How Do You Get the Information Out Effectively?
63(2)
Enrollee Satisfaction and Consumer Protections
65(10)
Proposed Legislative Changes to the Medicare Risk Program: A "Report Card"
75(5)
3 FINDINGS AND RECOMMENDATIONS
80(31)
REFERENCES 111(5)
REFERENCES CONSULTED 116(7)
APPENDIXES 123(230)
A Additional Commentary Regarding Choice Facilitating Organizations 123(2)
B Invitational Symposium Agenda 125(6)
C Symposium Participants 131(5)
D Commissioned Papers 136(1)
E The Structure and Accountability for Medicare Health Plans: Government, the Market, and Professionalism 137(22)
F Best Practices for Structuring and Facilitating Consumer Choice of Health Plans 159(36)
G Medicare Managed Care: Issues for Vulnerable Populations 195(41)
H Reaching and Educating Medicare Beneficiaries About Choice 236(34)
I What Information Do Consumers Want and Need: What Do We Know About How They Judge Quality and Accountability? 270(20)
J Medicare Managed Care: Protecting Consumers and Enhancing Satisfaction 290(36)
K Medicare Managed Care: Current Requirements and Practices to Ensure Accountability 326(12)
L What Should Be the Basic Ground Rules for Plans Being Able to Participate in the Medicare Managed Care Market? Case Study: The California Public Employees' Retirement System 338(15)
INDEX 353

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