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Related Experiment Videos

Medicare managed care: a consumer perspective.

J Dubow1

  • 1American Association of Retired Persons, Washington, DC, USA.

Managed Care Quarterly
|March 3, 1998
PubMed
Summary
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Congress must strengthen Medicare managed care by implementing comprehensive standards for quality, beneficiary protections, and oversight. This ensures beneficiaries receive accessible, high-quality healthcare options and adequate support services.

Area of Science:

  • Health policy
  • Healthcare administration
  • Medicare program reform

Background:

  • Managed care is expanding within the Medicare program.
  • There is a need to increase beneficiary confidence in managed care options.
  • Current safeguards and protections require enhancement.

Purpose of the Study:

  • To outline necessary actions for Congress regarding Medicare managed care.
  • To ensure beneficiaries receive available, accessible, high-quality care.
  • To recommend improvements in program standards and oversight.

Main Methods:

  • Policy analysis of the Medicare managed care program.
  • Review of existing beneficiary protections and quality assessment frameworks.
  • Identification of areas requiring legislative and administrative action.

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Main Results:

  • Comprehensive standards are needed for all Medicare contractors.
  • Strengthening quality improvement, grievance, and appeals processes is crucial.
  • Enhanced support for beneficiary counseling programs is recommended.

Conclusions:

  • Congress must act to bolster beneficiary trust in Medicare managed care.
  • Sufficient resources for the Health Care Financing Administration are essential for effective oversight.
  • Implementation of robust standards and protections will safeguard beneficiaries.