OBJECTIVES We examined the impact of access to care characteristics on health care use patterns among those veterans dually eligible for Medicare and Veterans Affairs (VA) services. METHODS We used a retrospective, cross-sectional design to identify veterans who were eligible to use VA and Medicare health care in calendar year 1999. We analyzed national VA utilization and Medicare claims data...

The costs of providing benefits to enrollees in private Medicare Advantage (MA) plans are slightly less, on average, than what traditional Medicare spends per beneficiary in the same county. However, MA plans that are able to keep their costs comparatively low are concen­trated in a fairly small number of U.S. counties. In the 25 counties where the cost differences between MA plans and traditio...

Estimates of the savings potential of a managed-care program for a Medicare retiree population in Michigan under a hypothetical Medicare insured group (MIG) are presented in this article. In return for receiving an experience-rated capitation payment, a MIG would administer all Medicare and employer complementary benefits for its enrollees. A study of the financial and operational feasibility o...

OBJECTIVES Using linked administrative data, to validate Medicare coverage estimates among adults aged 65 or older from the National Health Interview Survey (NHIS), and to assess the impact of a recently added Medicare probe question on the validity of these estimates. DATA SOURCES Linked 2005 NHIS and Master Beneficiary Record and Payment History Update System files from the Social Security ...

A fter rapid government payment increases in the midto late 1990s, Medicare+Choice plans now face sharply reduced annual increases in government payments for basic Medicare benefits (Gold 2001a). In response, Medicare+Choice plans are cutting back on supplemental benefits and raising premiums (Gold and Achman 2001; Achman and Gold 2002a, 2002c).These changes have increased outof-pocket spending...

BACKGROUND We wanted to evaluate the most recent, complete data related to the specific effects of the Balanced Budget Act of 1997 relative to the overall financial health of teaching hospitals. We also define cost report variables and calculations necessary for continued impact monitoring. METHODS We undertook a descriptive analysis of hospital cost report variables for 1996, 1998, and 1999,...

We evaluated the improvement in Department of Veterans Affairs (VA) race data completeness that could be achieved by linking VA data with data from Medicare and the Department of Defense (DOD) and examined agreement in values across the data sources. After linking VA with Medicare and DOD records for a 10% sample of VA patients, we calculated the percentage for which race could be identified in...

There is a clear need to develop better estimates of dual (Medicare and Medicaid) enrollees and the subpopulation of dual enrollees who receive full Medicaid benefits. Dual enrollees that may receive full Medicaid benefits include: qualified Medi-care beneficiaries (QMBs), specified low-income Medicare beneficiaries (SLMBs), and other dual beneficiaries—a group that includes medically needy/spe...

CONTEXT Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has generally been viewed as a policy disappointment. Enrollment has vacillated but has never come close to the penetration of managed care plans in the commercial insurance market or in Medicaid, and because of payment policy decisions and selection, the MA program is viewed as having added to cost rather than saving...