* Assist insurers in managing high-risk
enrollees and create a broader pool of people to absorb all other risk.
We examined whether reinsurance payments differ across plans after adjusting for
enrollee risk to understand how well plans manage drug spending for high-cost
enrollees.
Government Accountability Office say modernizing the traditional Medicare fee-for-service program benefits design could help cut many
enrollees' costs, discourage unnecessary use of care, and reduce demand for Medicare supplement (Medigap) insurance.
The variation in the post-subsidy cost of insurance for low-income participants allows the researchers to estimate
enrollees' willingness to pay for health insurance.
New/Late alternatively reflects whether the child was a new
enrollee, or in separate regressions, whether he or she was enrolled after a lapse in enrollment.
In this light, reproductive health professionals and advocates--including the American Congress of Obstetricians and Gynecologists, the Guttmacher Institute, the National Family Planning and Reproductive Health Association, the National Health Law Program, the National Women's Law Center and Planned Parenthood Federation of America--have pressed the agency to clarify Medicaid's guarantees for reproductive health coverage, bolster its protections for patient confidentiality, ensure
enrollees' access to qualified providers and attain the delicate balance between protecting patients' health and respecting religious objections by plans and providers.
We sought to develop a methodology that would enable us to examine all cross-state migration that occurred during 2005-2007, even though Medicaid
enrollee migration was affected by Hurricane Katrina during these years.
This unique feature of the Medicare drug benefit represents a gap in coverage where Part D
enrollees, other than those qualifying for the benefit's Low-Income Subsidy [LIS], have been required to pay the full cost of their drugs," says the study.
The demand for medical care is a function of potentially observable
enrollee characteristics (X), such as age, gender, and self-reported health, and characteristics (Z) that are typically unobserved, such as an individual's preferences for medical care and his unmeasured health status.
There is nothing wrong with Medicare's basic cost containment methods, certainly nothing so wrong as to warrant the herding of millions of
enrollees into inefficient health insurance companies, many of which rely on rationing to control spending.
The key areas to investigate are the number of office visits allowed per year, the location and office hours available, and the dollar cost per visit to the
enrollee.
They are easy for health care providers to calculate at the time of service and provide the
enrollee advance knowledge of the cost of service.
