If the Medicare fee-for-service
program offered enrollees the kind of annual out-of-pocket spending cap that Affordable Care Act-compliant private major medical plans now provide, "the addition of an annual cap would reduce the need of some beneficiaries to purchase supplemental insurance," James Cosgrove, a GAO director, writes in a new GAO report.
Incorporating quality metrics into fee-for-service
Based on an average payment per discharge of nearly $8,400 in 2007, bringing Medicare's fee-for-service
preventable hospitalizations down to the same level as the ACHP plans would have saved the program $4.
But, he noted in his opening statement that in Montana, more than 90% of all Medicare Advantage enrollees are in private fee-for-service
plans, rather than in the health maintenance organizations or preferred provider organizations.
The seven private fee-for-service
Medicare plans that recently signed an agreement with the CMS to suspend their marketing efforts are United Healthcare, Humana, WellCare, Universal American Financial Corporation (Pyramid), Coventry, Sterling, and Blue Cross Blue Shield of Tennessee.
At its best, a fee-for-service
provider is a partner in the client's business, providing the contracted services today and looking toward improvements to meet future needs.
This might be a more cost-effective solution and offer a higher quality of life than prescribing costly medications or continually hospitalizing the individual when she has asthmatic attacks-which would be the only possible interventions under fee-for-service
Congress authorized private fee-for-service
plans in the Balanced Budget Act of 1997 as an alternative way to provide flexible coverage with affordable premiums to Medicare benefiaries.
INNOVATIVE HMO NURSING HOME PROGRAMS may have the potential to keep more nursing home residents out of emergency rooms and hospitals, ultimately providing better care at a lower cost than traditional fee-for-service
On the basis of little more than HMO assertions that they were more efficient than Medicare, HCFA set the HMO reimbursement rate 5 percent below the rate at which HCFA reimburses doctors and hospitals in the traditional, fee-for-service
The project will give Medi-Cal beneficiaries enrolled with the California Children's Service program the option of staying on a fee-for-service
plan or switching to one of the two health care plans.
That report focused on the elderly population living in the community who received care in the fee-for-service