, details the different types of private plan options available to people on Medicare. These include Medicare Advantage plans (such as Medicare HMOs, PPOs and private fee-for-service plans) and new stand-alone prescription drug plans.

• In 2006, all Medicare beneficiaries have access to at least one type of private Medicare Advantage plan, up from 77% in 2004. The increase in access stems largely from the creation of new Medicare regional PPOs and the expansion of private Medicare fee-for-service plans. About 13% of Medicare beneficiaries (5 million) are enrolled in private Medicare Advantage plans.

• The introduction of regional PPOs in 2006 and the growth in private fee-for-service plans have expanded access to private plans in rural areas, but HMOs continue to be more common in urban areas. Medicare HMOs are not offered in eight states: Alaska, Delaware, Maine, Montana, North Dakota, South Dakota, Vermont and Wyoming.

• Special needs plans are available in all but nine states. These plans serve beneficiaries who are eligible for Medicare and Medicaid, institutionalized beneficiaries and those with severe, chronic, and/or disabling conditions.

Issue Brief (.pdf)

describes key characteristics of the organizations that offer the new Medicare drug benefit and analyzes how companies are positioning themselves to attract Medicare enrollees.

• Seven of the 10 organizations that sponsor stand-alone prescription drug plans nationwide are based in commercial insurance firms with substantial Medicare Advantage experience, and three of the 10 firms are in the pharmacy benefit management and service sector.

• Nine of the 10 organizations that sponsor stand-alone prescription drug plans nationwide offered a Medicare-endorsed discount card in 2004 and 2005 or partnered with a firm that did.

• Most of the major firms that dominated the Medicare Advantage program prior to 2006 have expanded their options and offer stand-alone prescription drug plans to appeal to a broader range of beneficiaries.

Issue Brief (.pdf)

This report reviews the role of community health centers in the nation’s health care safety net. Today, over 1,000 federally funded and “look-alike” health centers serve 14.3 million people, three-quarters of whom are uninsured or covered by Medicaid.

As health centers look toward legislative reauthorization in 2006, they face several policy challenges reviewed in this report, including an increase in the uninsured populations, potential decreases in Medicaid revenue, and a need to increase health centers’ workforce.

Report (.pdf)

This report examines the creation and implementation of Utah’s waiver through interviews with key stakeholders and an analysis of state enrollment data and quarterly reports. Also see Health Affairs article, Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from Utah

Report (.pdf)

Because over seven million elderly and disabled individuals are entitled to benefits under both Medicare and Medicaid, policy changes in one program not only affect both coverage and spending in the other but also impact access to services by individuals eligible for both programs. This primer summarizes two key policy interactions and includes a quick reference table of the most significant linkages between the two programs.

Issue Brief (.pdf)

This chartpack reviews the President’s FY 2007 budget request to Congress and highlights overall budget assumptions and funding for major health programs. It begins with a description of the federal budget process, followed by summary information on the overall composition of the Administration’s budget. Overall, the budget includes net reductions for Medicare, Medicaid, and other health programs administered by the Department of Health and Human Services. The budget also includes additional expenditures for proposals to promote health savings accounts.

Issue Brief .pdf)

With the enactment of the Deficit Reduction Act of 2005, states have gained increased flexibility over benefits and cost sharing for certain currently eligible Medicaid populations without having to obtain a waiver of Medicaid rules. New findings from the Kaiser Family Foundation’s 2004 survey of the experiences of Medicaid beneficiaries under Utah’s 2002 waiver provide insights into the implications of limited benefits for the low-income population. The results are featured in the March/April edition of Health Affairs.

Under a waiver, Utah expanded coverage for primary care services to low-income uninsured parents and adults, offsetting costs by limiting benefits and raising cost sharing for poor parents, most with incomes below 54 percent of the federal poverty level, already covered by Medicaid.

The study suggests that a coverage expansion approach that relies on savings from reducing coverage for current beneficiaries and provides a limited benefit has important limitations. Although the primary care expansion helped fill a critical need for low-income uninsured adults, more than three-fourths of primary care enrollees needed services beyond the scope of their coverage. Similarly, more than two-thirds of the Medicaid beneficiaries subject to coverage reductions needed care beyond their coverage. The limited coverage or the cost associated with services, led one in three newly insured people to miss or postpone care and over half reported difficulty paying for medical expenses. Among the parents with coverage reductions, nearly a quarter reported missing or postponing care and over a third said they had difficulty paying medical expenses.

A case study report examining the creation and implementation of Utah’s waiver through interviews with key stakeholders and an analysis of state enrollment data and quarterly reports is also available.

Health Affairs article, Can States Stretch The Medicaid Dollar Without Passing The Buck? Lessons From Utah (Free Access)Abstract Full Text

A Case Study of the Utah Primary Care Network Waiver: Insights into Its Development, Design, and Implementation

Should physicians be required to tell patients if a preventable medical error resulting in serious harm is made in their OWN care, or not?

88

Yes

9

No

2

(DO NOT READ) Don’t know

1

(DO NOT READ) Refused

If a preventable medical error that resulted in serious harm were made in your care, how likely do you think the doctor would be to tell you– very likely, somewhat likely, not very likely, or not at all likely?

23

Very likely

31

Somewhat likely

25

Not very likely

19

Not at all likely

2

(DO NOT READ) Don’t know

*

(DO NOT READ) Refused

Did the doctor or the health professionals involved tell you that a medical error had been made in your or your family member’s treatment, or didn’t they tell you?

Based on those involved with a preventable medical error (n=685)

28

Told you

70

Did not tell you

2

Don’t know/Refused

Survey by Henry J. Kaiser Family Foundation, Agency for Healthcare Research and Quality, Harvard School of Public Health. Methodology: Fieldwork Conducted by Princeton Survey Research Associates International, July 7-September 5, 2004 and based on telephone interviews with a national adult sample of 2,012. 

Assuming that medical errors are reported, should hospital reports of serious medical errors be confidential and only used to learn how to prevent future mistakes or should they also be released to the public?

31

Confidential

63

Released to the public

4

(DO NOT READ) Don’t know

1

(DO NOT READ) Refused

Which one of the following statements comes closer to your views on how medical errors that result in serious injury or harm should be handled?  (CATEGORIES READ AND ROTATED)

92

A. Reporting of serious medical errors should be REQUIRED (OR)

6

B. Reporting of serious medical errors should be VOLUNTARY (OR)

2

(DO NOT READ) Don’t know/Refused

Survey by Henry J. Kaiser Family Foundation, Agency for Healthcare Research and Quality, Harvard School of Public Health. Methodology: Fieldwork Conducted by Princeton Survey Research Associates International, July 7-September 5, 2004 and based on telephone interviews with a national adult sample of 2,012

About how many Americans do you think die in hospitals each year as a result of a preventable medical error?  (ANSWER CATEGORIES READ)

18

500

31

5,000

18

50,000

9

100,000 OR

5

500,000 or more

16

(DO NOT READ) Don’t know

Survey by Henry J. Kaiser Family Foundation, Agency for Healthcare Research and Quality, Harvard School of Public Health. Methodology: Fieldwork Conducted by Princeton Survey Research Associates International, July 7-September 5, 2004 and based on telephone interviews with a national adult sample of 2,012.