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  • The Landscape of Private Firms Offering Medicare Prescription Drug Coverage in 2006

    Issue Brief

    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…

  • The Emerging Role of Group Medicare Private Fee-for-Service Plans

    Issue Brief

    This issue brief examines the recent boom in Medicare Advantage enrollment attributable to employers contracting with Private Fee-for-Service (PFFS) plans to cover their Medicare-eligible retirees. Between 2006 and 2008, the number of Medicare beneficiaries enrolled in Medicare Advantage group plans nearly doubled from 900,000 to nearly 1.7 million as of June 2008; most of this growth is attributable to contracts between employers and PFFS plans. The issue brief, prepared for the Foundation by Avalere Health,…

  • Medicare Prescription Drug Improvement and Modernization Act Implementation Timeline: June 2004 – December 2006 Key Dates

    Report

    Key Implementation Dates for the Medicare Prescription Drug Benefit This timeline presents important dates and deadlines of key implementation activities related to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). It runs from the beginning of 2005 through the end of 2006, the first year of the new Medicare drug benefit. Some of these dates are defined in the MMA statute, while others are from the final rule issued by the Centers…

  • The Obama Administration’s 2010 Call Letter for Medicare Advantage and Prescription Drug Plans: Implications for Beneficiaries

    Issue Brief

    On March 30, 2009, the Centers for Medicare & Medicaid Services issued the 2010 “call letter,” which functions as a request for proposals to private health insurers and organizations that want to sponsor Medicare Advantage Plans or Medicare Prescription Drug Plans. This issue brief reviews the call letter — the first issued by the Obama Administration — and examines the implications for beneficiaries of some of the proposed changes, including its emphasis on accountability of health plan sponsors, promoting…

  • Explaining Health Reform: Medicare and the New Independent Payment Advisory Board

    Issue Brief

    This brief describes how the new board created under the 2010 health reform law is expected to limit the growth in Medicare spending over time. Starting in 2014, if projected per capita Medicare spending exceeds targets set in the law, the board must recommend ways to reduce Medicare spending, while maintaining quality and access to care for beneficiaries. The board’s recommendations automatically take effect the next year unless Congress adopts an alternative plan to achieve…

  • Explaining Health Reform: Key Changes in the Medicare Advantage Program

    Issue Brief

    This brief examines the changes in the 2010 health reform law affecting the Medicare Advantage program, which gives beneficiaries the option of enrolling in private insurance plans for their Medicare benefits, instead of the traditional fee-for-service program. The reform law will gradually reduce Medicare payments to these plans to bring the average payment closer to the costs of traditional fee-for-service Medicare, while rewarding plans with high-quality ratings. The brief also describes new benefit requirements for…

  • Issue Briefs Describe Changes in Private Plan Market and Effects on Medicare Beneficiaries

    Issue Brief

    These two issue briefs describe the different types of private plan options available to people on Medicare, identify key characteristics of the organizations offering the new Medicare drug benefit, and analyze how companies are positioning themselves to attract Medicare enrollees. The Growth of Private Plans in Medicare, 2006 The Landscape of Private Firms Offering Medicare Prescription Drug Coverage in 2006

  • Study Finds Advertising By Insurers Favors Medicare Advantage Over Stand-Alone Drug Plans

    Issue Brief

    As the marketing period for 2009 Medicare plans nears, the Kaiser Family Foundation Kaiser Family Foundation issued a report analyzing the content and frequency of television, print and radio advertisement for private Medicare plans that ran nationally or in one of three local media markets (Miami/Fort Lauderdale, Fla.; Phoenix, Ariz.; and Greensboro, N.C) during the marketing and enrollment period for 2008 plan offerings. The study finds that insurers last year placed three times more advertisements…

  • What’s in the Stars? Quality Ratings of Medicare Advantage Plans, 2010

    Issue Brief

    NEW: Foundation brief looks at implications of 2011 quality ratings for Medicare Advantage plans. The Centers for Medicare and Medicaid Services (CMS) rates the relative quality of the private plans that are offered to Medicare beneficiaries through the Medicare Advantage program as a way of aiding beneficiaries who are considering enrolling in such a private plan. CMS rates Medicare Advantage plans on a one to five-star scale, with five stars representing the highest quality. This…

  • Grievance and Appeals Procedures: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Sara Rosenbaum, J.D., Director of the Center for Health Services Research and Policy at George Washington University, examines the procedures for resolving beneficiaries' grievances and appeals under the new Medicare drug benefit. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)