Abstract: Part 1 Placing Medicare in context: why examine Medicare now? economic status of older Americans - prospects for the future, burdens from health spending the economic status of disabled persons the problem of rising healthcare costs - prices, use of services Medicare as part of federal budget the specific financing issues facing Medicare. Part 2 Assuring access: the genesis - evolution of the legislation, Medicare and its goals expansion in 1972 other changes in access who gets what? - rising burdens of Medicare cost sharing, geographic variation. Part 3 Containing costs - impact on providers: sources of growth in Medicare spending changing Medicare's relationship with providers hospitals take the first hit - how PPS works, the immediate response in delivery of care, impacts on hospitals, impact on Medicare administration, changes to improve hospital payment physician payment reform - details of the Medicare fee schedule, the impact of the fee schedule other provider changes - home health services, skilled nursing facility care health maintenance organizations. Part 4 Containing costs - impacts on beneficiaries: direct changes in beneficiary cost sharing - sources of higher beneficiary burderns, offsetting reductions in beneficiary burdens distribution of the impact PPS and indirect burdens on beneficiaries - effects of shorter hospital stays, shifting the site of service, effects of less inpatient care quality of care - Medicare physician payment reform and quality, HMOs and quality, peer review organizations, using effectiveness studies to improve quality, program satisfaction. Part 5 The Medicare catastrophic coverage act: recognizing the need for catastrophic protection - setting the stage for the legislation evolution of the legislation - defining the benefits, financing the Medicare catastrophic coverage act - passage and repeal - overall beneficiary impact, winners and losers, the beginning of the end, repeal lessons for health policy - politics of the supplemental premium. Part 6 Marginal changes and the future: restructuring cost sharing co-containment strategies - hospitals, physicians, other changes in provider payment HMOs and other managed-care approaches - effectiveness studies, cuts directed at beneficiaries modest benefit expansions - administrative simplifications, hospice care and the last year of life, preventing services. Part 7 reducing the cost of Medicare: shifting risks - balancing choice and risk, vouchers, capitated care option reducing coverage - making Medicare the insurer of last resort. (Part contents)
Publication Year: 1993
Publication Date: 1993-03-16
Language: en
Type: book
Access and Citation
Cited By Count: 54
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