Medicare
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American Economic Journal: Applied Economics: Health Care Spending and Utilization in Public and Private Medicare
Tags: American Economic Journal: Applied Economics, Medicare, Medicare Advantage, Peer Reviewed Journals, Spending, Utilization
Read more: American Economic Journal: Applied Economics: Health Care Spending and Utilization in Public and Private MedicareAbstract: We compare health care spending in public and private Medicare using newly available claims data from Medicare Advantage (MA) insurers. MA insurer revenues are 30 percent higher than their health care spending. Adjusting for enrollee mix, health care spending per enrollee in MA is 9 to 30 percent lower than in Traditional Medicare (TM),…
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INQUIRY The Journal of Health Care Organization, Provision, and Financing: How do the Hospital Prices Paid by Medicare Advantage Plans and Commercial Plans Compare with Medicare Fee-for-Service Prices?
Tags: Commercially Insured, Inpatient Spending, Medicare, Medicare Advantage, Peer Reviewed Journals
Read more: INQUIRY The Journal of Health Care Organization, Provision, and Financing: How do the Hospital Prices Paid by Medicare Advantage Plans and Commercial Plans Compare with Medicare Fee-for-Service Prices?ABSTRACT The prices that private insurers pay hospitals have received considerable attention in recent years, but most of that literature has focused on the commercially insured population. Although nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, little is known about the prices paid to hospitals by the private insurers that…
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New York Times: Medicare Advantage Spends Less on Care, So Why Is It Costing So Much?
Read more: New York Times: Medicare Advantage Spends Less on Care, So Why Is It Costing So Much?By: Austin Frakt The Medicare Advantage program was supposed to save taxpayers money by allowing insurers to offer older Americans private alternatives to Medicare. The plans now cover 19 million people, a third of all those who qualify for Medicare. Enrollee satisfaction is generally high, and studies show that plans offer higher quality than traditional…
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Health Affairs: Medicare Competitive Bidding Program Realized Price Savings For Durable Medical Equipment Purchases
Read more: Health Affairs: Medicare Competitive Bidding Program Realized Price Savings For Durable Medical Equipment PurchasesABSTRACT: From the inception of the Medicare program there have been questions regarding whether and how to pay for durable medical equipment, prosthetics, orthotics, and supplies. In 2011 the Centers for Medicare and Medicaid Services (CMS) implemented a competitive bidding program to reduce spending on durable medical equipment and similar items. Previously, CMS had used…
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Congressional Budget Office Working Paper Series: An Analysis of Private-Sector Prices for Hospital Admissions
Tags: CBO, Commercially Insured, Geographic Variation, Inpatient Spending, Medicare, Medicare Advantage, Outpatient Spending
Read more: Congressional Budget Office Working Paper Series: An Analysis of Private-Sector Prices for Hospital AdmissionsABSTRACT: Prices for hospital admissions have received considerable attention in recent years, both because they are an important component of health care spending and because they can vary widely. In this paper, we use 2013 claims data from three large insurers to examine the hospital payment rates of those insurers in their commercial plans and…
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Health Services Research: Payer Type and Low‐Value Care: Comparing Choosing Wisely Services across Commercial and Medicare Populations
Read more: Health Services Research: Payer Type and Low‐Value Care: Comparing Choosing Wisely Services across Commercial and Medicare PopulationsABSTRACT Objective: To compare low‐value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low‐value care. Data Sources: 2009–2011 national Medicare and commercial insurance administrative data. Design: We created claims‐based algorithms to measure seven Choosing Wisely‐identified low‐value services and examined the correlation between commercial…
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NBER Working Paper: Healthcare Spending and Utilization in Public and Private Medicare
Tags: Geographic Variation, Medicare, Medicare Advantage, NBER, Peer Reviewed Journals, Value Based Care
Read more: NBER Working Paper: Healthcare Spending and Utilization in Public and Private MedicareABSTRACT: We compare healthcare spending in public and private Medicare using newly available claims data from Medicare Advantage (MA) insurers. MA insurer revenues are 30 percent higher than their healthcare spending. Healthcare spending is 25 percent lower for MA enrollees than for enrollees in traditional Medicare (TM) in the same county with the same risk…
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Health Affairs: Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare Pays
Tags: Commercially Insured, Health Affairs, Inpatient Spending, Medicare, Medicare Advantage, Outpatient Spending, Peer Reviewed JournalsRead more: Health Affairs: Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare PaysABSTRACT There is ongoing debate about how prices paid to providers by Medicare Advantage plans compare to prices paid by fee-for-service Medicare. We used data from Medicare and the Health Care Cost Institute to identify the prices paid for hospital services by fee-for-service (FFS) Medicare, Medicare Advantage plans, and commercial insurers in 2009 and 2012….