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Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

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M+C plan county exit decisions 1999-2001: implications for payment policy.

Rachel Halpern¹

¹University of Minnesota, Minneapolis 55455, USA. rachel.halpern@i3magnifi.com

Health Care Financing Review

|February 13, 2007

Summary

Medicare+Choice (M+C) payment increases did not consistently impact plan participation. Plan retention varied by year and commitment, though simulations suggest higher payments could improve retention.

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Area of Science:

Health Policy
Health Economics
Medicare Program Analysis

Background:

Private plan participation in Medicare+Choice (M+C) has declined since 1999.
Legislative efforts to counteract this trend have primarily involved increasing payments.

Purpose of the Study:

To analyze the impact of payment increases on Medicare+Choice plan decisions.
To evaluate the effectiveness of payment adjustments in retaining private plans within the M+C program.

Main Methods:

Analysis of M+C plan decisions regarding county participation from 1999-2000 and 2000-2001.
Simulations to compare the 1997 Balanced Budget Act (BBA) payment methodology with previous systems.

Main Results:

Payment amounts were a factor but did not consistently influence M+C plans' decisions to continue or drop counties.
Plan retention varied significantly based on the specific year and the plans' overall intention to remain in the M+C program.
Simulations indicated that M+C plans generally benefited more from the BBA payment methodology than from the prior system.

Conclusions:

Substantial payment increases alone may not be sufficient to ensure consistent private plan participation in Medicare+Choice.
Plan retention in M+C is influenced by a complex interplay of payment levels, policy years, and strategic decisions by participating organizations.
Policy adjustments, such as significant payment increases, show potential for enhancing plan retention in Medicare+Choice.