CIS/Index
Copyright © 1999, Congressional Information
Service, Inc.
99 CIS H 27151
TITLE:
Medicare+Choice: An Examination of the Risk Adjuster
CIS-NO: 99-H271-51
SOURCE: Committee on Commerce. House
DOC-TYPE: Hearing Retrieve
the full text of testimony
DATE: Feb. 25, 1999
LENGTH:
iii+117 p.
CONG-SESS: 106-1
ITEM-NO: 1019-A-01; 1019-B-01
SUDOC: Y4.C73/8:106-10
MC-ENTRY-NO: 99-20239
CIS DOCUMENT ON DEMAND: 1-800-227-2477 (Full Text Reproductions)
INCLUDED IN LEGISLATIVE HISTORY OF: P.L.
106-113
SUMMARY:
Committee Serial No. 106-10.
Hearing before the Subcom on Health and Environment to assess Health Care
Financing Administration (HCFA) efforts to implement a new risk
adjustment payment model to predict the costs of individual beneficiary
medical treatment under the Medicare+Choice Program, enacted under the Balanced
Budget Act of 1997, which allows medicare recipients to participate in a variety
of private managed health care plans, including health maintenance
organizations.
Under proposed risk adjustment
methodology, data on individual beneficiaries use of health care services in a
given year will be used to adjust payment for each beneficiary enrolled in a
Medicare+Choice plan the following year.
CONTENT-NOTATION: Medicare payments to managed care
plans, policy changes review
DESCRIPTORS:
SUBCOM ON HEALTH AND ENVIRONMENT. HOUSE; MEDICARE;
GOVERNMENT CONTRACTS AND PROCUREMENT; MEDICAL ECONOMICS; MANAGED HEALTH CARE;
RISK ANALYSIS; HEALTH CARE FINANCING ADMINISTRATION; BALANCED BUDGET ACT; HEALTH
MAINTENANCE ORGANIZATIONS
99-H271-51 TESTIMONY NO: 1
Feb. 25, 1999 p. 7-34
WITNESSES (and witness notations):
HASH, MICHAEL M. (Deputy Administrator, HCFA)
STATEMENT AND DISCUSSION:
Status of risk
adjustment methodology implementation; issues involved in
Medicare+Choice program.
CONTENT NOTATION:
Medicare payments to managed care plans, policy changes
review
99-H271-51 TESTIMONY NO: 2
Feb. 25, 1999 p. 35-61
WITNESSES (and witness notations):
WILENSKY, GAIL R. (Chair, Medicare Payment Advisory
Commission)
SCANLON, WILLIAM J. (Director, Health
Financing and Public Health Issues, Health, Education, and Human Services
Division, GAO)
STATEMENTS AND DISCUSSION:
Merits of revising Medicare+Choice payment policies, with
views on proposed risk adjustment methodology; perspectives on
Medicare+Choice program.
CONTENT NOTATION:
Medicare payments to managed care plans, policy changes
review
TESTIMONY DESCRIPTORS:
MEDICARE
PAYMENT ADVISORY COMMISSION; GENERAL ACCOUNTING OFFICE
99-H271-51 TESTIMONY NO: 3 Feb. 25, 1999 p. 61-79
WITNESSES (and witness notations):
MILLER,
ANN (Board Member, AARP)
ARCHER, DIANE S. (Executive
Director, Medicare Rights Center)
WEGNER, NONA B. (Senior
Vice President, Seniors Coalition)
STATEMENTS AND DISCUSSION:
Desirability of improving Medicare+Choice payment
policies, including implementation of accurate risk adjustment
methodology.
CONTENT NOTATION:
Medicare
payments to managed care plans, policy changes review
TESTIMONY
DESCRIPTORS:
AARP
99-H271-51
TESTIMONY NO: 4 Feb. 25, 1999 p. 79-117
WITNESSES (and witness notations):
DISCENZA, JUDITH A.
(Vice President, Blue Cross and Blue Shield of Florida)
SCHUB, CRAIG S. (President, Secure Horizons USA;
representing PacifiCare Health Systems)
MARGULIS, HEIDI
(Vice President, Government Affairs, Humana, Inc)
BERTKO,
JOHN (Principal, Reden & Anders, Ltd)
JOHNSON, KIRK
(Senior Vice President, CNA Health Partners; representing Health Insurance
Association)
STATEMENTS AND DISCUSSION:
Shortcomings of HCFA implementation of risk
adjustment plan, including methodological flaws in the risk
adjustment model; recommendations regarding Medicare+Choice program.
CONTENT NOTATION:
Medicare payments to
managed care plans, policy changes review
TESTIMONY DESCRIPTORS:
BLUE CROSS AND BLUE SHIELD OF FLORIDA 
