Variations in elderly Medicare beneficiaries' health service use are examined using a 100-percent sample of fee-for-service (FFS) claims data from Alabama, Iowa, and Maryland. Provider specialty, group practice type, practice size, and location are found to be significant factors affecting hospital and ambulatory care utilization and cost, after controlling for patient and regional characterist...

Increasingly in U.S. public insurance programs, the state finances competing, capitated health plans rather than using a fee-for-service (FFS) model. We study how highand low-cost infants (blacks and Hispanics, respectively) are affected by the transition from FFS to Medicaid managed care (MMC). We find that black-Hispanic infant health disparities widen—e.g., black mortality increases by 12% w...

Medicaid programs increasingly finance competing, capitated managed care plans rather than administering fee-for-service (FFS) programs. We study how the transition from FFS to managed care affects highand low-cost infants (blacks and Hispanics, respectively). We find that blackHispanic disparities widen—e.g., black mortality and pre-term birth rates increase by 15% and 7%, respectively, while ...

The Medicare Program is conducting a randomized trial of care management services among fee-for-service (FFS) beneficiaries called the Medicare Health Support (MHS) pilot program. Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries...

The study compares racial differences in access to highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) patients under Medicaid managed care and Medicaid fee-for-service (FFS). This study uses the HIV Cost and Services Utilization Study (HCSUS) data set. The analysis includes Black and White Medicaid enrollees with HIV/AIDS in 1996. Logistic regression is used to ...

Medicare policymakers are considering testing population-based disease management (PDM) programs under fee-for-service (FFS) Medicare as a way to improve health and cost outcomes for selected subgroups of chronically ill beneficiaries. This paper provides a brief overview of how PDM programs are evolving in the private sector and describes how they differ from other approaches already being tes...

The Medicare Payment Advisory Commission (MedPAC) has identified two important problems with the Medicare+Choice (M+C) program: nationwide geographic inequity in government-financed benefits, and unequal government payments for M+C plans versus fee-for-service (FFS) Medicare in the same market area. MedPAC concludes that both problems cannot be solved simultaneously. We argue that both problems...

Based on data from the 2004 National Physician Survey, physicians whose primary payment method was fee-for-service saw more patients per week than physicians remunerated by other methods, including salary or blended payments. This result did not change when examined according to specialty or specialty grouping (Table 1), physician age (Table 2) Family physicians versus specialists, type of prac...

OBJECTIVES The primary objective of this paper is to compare cervical cancer screening rates of family physicians in Ontario's two dominant reformed practice models, Family Health Group (FHG) and Family Health Organization (FHO), and traditional fee-for-service (FFS) model. Both reformed models formally enrol patients and offer extensive pay-for-performance incentives; however, they differ by r...

Medicare private fee-for-service (PFFS) plans are paid like other Medicare Advantage (MA) plans but are exempt from many MA requirements. Recently, Congress set average payments well above the costs of traditional fee-for-service (FFS) Medicare, inducing dramatic increases in PFFS plan enrollment. This has significant implications for Medicare's budget, provoking calls for policy change. We pre...