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Understanding Medicare risk contracting

D L Olmstead

    Pennsylvania Medicine
    |March 1, 1997
    PubMed
    Summary
    This summary is machine-generated.

    Medicare managed care plans offer beneficiaries risk, cost, and health care prepayment contracts. This article focuses on answering common questions regarding Medicare risk contracts.

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    Area of Science:

    • Health Services Research
    • Public Health Policy
    • Healthcare Management

    Background:

    • Medicare beneficiaries are increasingly enrolled in managed care plans.
    • Managed care organizations (MCOs) participate in Medicare through various contract types.
    • Understanding these contract types is crucial for beneficiaries and policymakers.

    Purpose of the Study:

    • To clarify the structure and function of Medicare managed care.
    • To address frequently asked questions specifically about Medicare risk contracts.
    • To provide foundational knowledge for a series on Medicare managed care.

    Main Methods:

    • This article is the first in a series.
    • It synthesizes information to answer common queries.

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  • No primary data collection or analysis is described.

    • Main Results:

    • Medicare beneficiaries can enroll in managed care through risk, cost, or health care prepayment plans.
    • Risk contracts represent one primary model for Medicare managed care delivery.
    • Key aspects of risk contracts are detailed to address common questions.

    Conclusions:

    • Risk contracts are a significant component of Medicare managed care.
    • Further articles in the series will explore other aspects of Medicare managed care.
    • Clarifying contract types enhances understanding of Medicare options.