CIS/Index
Copyright © 1999, Congressional Information
Service, Inc.
99 CIS H 27193
TITLE:
Medicare+Choice: An Evaluation of the Program
CIS-NO: 99-H271-93
SOURCE: Committee on Commerce. House
DOC-TYPE: Hearing Retrieve
the full text of testimony
DATE: Aug. 4, 1999
LENGTH:
iii+172 p. il.
CONG-SESS: 106-1
ITEM-NO: 1019-A-01;
1019-B-01
SUDOC: Y4.C73/8:106-52
CIS DOCUMENT ON DEMAND:
1-800-227-2477 (Full Text Reproductions)
INCLUDED IN LEGISLATIVE
HISTORY OF: P.L.
106-113
SUMMARY:
Committee Serial No. 106-52.
Hearing before the Subcom on Health and Environment to examine the need to
reform the payment system for the Medicare+Choice program, enacted under the
Balanced Budget Act of 1997 to allow medicare recipients to participate in a
variety of private managed health care plans.
Assesses Health
Care Financing Administration (HCFA) implementation of a risk adjustment payment
model to predict the costs of individual beneficiary medical treatment under the
Medicare+Choice program.
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.
Supplementary material
(p. 133-172 and throughout) includes correspondence, a witness's written replies
to Subcom questions, and:
a. Lieberman, Steven M. (CBO),
medicare payments to managed care plans, statement prepared for Senate Finance
Committee, June 9, 1999 (p. 24-31).
b. GAO,
"Medicare+Choice: Reforms Have Reduced, But Likely Not Eliminated, Excess Plan
Payments" prepared for Congress, June 1999 (p. 80-99).
c.
Actuarial Research Corp., "Disturbing Truths and Dangerous Trends: The Facts
About Medicare Beneficiaries and Prescription Drug Coverage" prepared for HHS,
July 1999, with graphs (p. 115-130).
CONTENT-NOTATION:
Medicare payments to managed care plans, policy changes review
DESCRIPTORS:
SUBCOM ON
HEALTH AND ENVIRONMENT. HOUSE; MEDICARE; GOVERNMENT EFFICIENCY; GOVERNMENT
CONTRACTS AND PROCUREMENT; MEDICAL ECONOMICS; MANAGED HEALTH CARE; RISK
ANALYSIS; CONGRESSIONAL BUDGET OFFICE; GENERAL ACCOUNTING OFFICE; DEPARTMENT OF
HEALTH AND HUMAN SERVICES; STATISTICAL DATA: HEALTH AND VITAL STATISTICS; DRUGS;
BALANCED BUDGET ACT; HEALTH CARE FINANCING ADMINISTRATION
99-H271-93
TESTIMONY NO: 1 Aug. 4, 1999 p. 15-24, 31-47, 135-172
WITNESSES (and witness notations):
BERENSON, ROBERT A. (Director, Center for Health Plans and
Providers, HCFA)
STATEMENT AND DISCUSSION:
Overview of Administration proposals to reform
Medicare+Choice program; details on HCFA implementation of risk adjustment
payment model; problems with medicare payment reforms using 1997 rates as a
standard for future payments, citing overpayments to providers in 1997; response
to concerns that Medicare+Choice is less effective than traditional
fee-for-service medicare.
INSERTION:
--
HCFA, "Medicare+Choice: Changes for the Year 2000, An Analysis of the
Medicare+Choice Program and How Beneficiaries Will Be Affected by Changes" Sept.
1999, with graphs and tables (p. 140-172).
CONTENT NOTATION:
Medicare payments to managed care plans, policy changes
review
TESTIMONY DESCRIPTORS:
STATISTICAL
DATA: HEALTH AND VITAL STATISTICS
99-H271-93 TESTIMONY
NO: 2 Aug. 4, 1999 p. 48-79, 100-114, 131-133
WITNESSES (and witness notations):
IGNAGNI, KAREN
(President and CEO, American Association of Health Plans)
POWELL, JOHN (Vice President, Government Affairs, Seniors
Coalition)
CANJA, ESTHER (President-Elect, AARP)
MOON, MARILYN (Senior Fellow, Urban Institute)
MALAVSKY, MORTON (Rabbi) (Medicare+Choice participant)
STATEMENTS AND DISCUSSION:
Concerns about
proposed changes to Medicare+Choice program payment structure; problems with
risk adjustment payment model, citing inadequacy of risk calculation
methodologies; need for Medicare+Choice payment reform to
prevent more withdrawals of managed care plans from the program.
Implications of proposed risk adjustment payment model for
medicare beneficiaries quality of care; pros and cons of Medicare+Choice reform
proposals.
CONTENT NOTATION:
Medicare
payments to managed care plans, policy changes review
TESTIMONY
DESCRIPTORS:
AMERICAN ASSOCIATION OF HEALTH PLANS
