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Medicare preferred provider organization demonstration: plan offerings and beneficiary enrollment.

Pope GC, Greenwald L, Kautter J, Olmsted E, Mobley L - Health Care Financ Rev (2006)

Bottom Line: As preferred provider organizations (PPOs) become the dominant model of managed health care in the private sector, policymakers have increasingly viewed PPOs as an attractive option for Medicare.In part to understand how PPOs might operate under the Medicare Program, CMS launched the Medicare PPO demonstration in January 2003.In this article, we examine how PPOs have operated so far under the demonstration, including PPO availability and market entry; premiums, benefits, and beneficiary cost sharing; and enrollment, market share, enrollee characteristics, and disenrollment to date.

View Article: PubMed Central - PubMed

Affiliation: RTI International, Waltham, MA 02452, USA. gpope@rti.org

ABSTRACT
As preferred provider organizations (PPOs) become the dominant model of managed health care in the private sector, policymakers have increasingly viewed PPOs as an attractive option for Medicare. In part to understand how PPOs might operate under the Medicare Program, CMS launched the Medicare PPO demonstration in January 2003. In this article, we examine how PPOs have operated so far under the demonstration, including PPO availability and market entry; premiums, benefits, and beneficiary cost sharing; and enrollment, market share, enrollee characteristics, and disenrollment to date.

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Enrollment in the Preferred Provider Organization Demonstration: 2003-2004
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Related In: Results  -  Collection


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f4-hcfr-27-3-095: Enrollment in the Preferred Provider Organization Demonstration: 2003-2004

Mentions: Figure 4 depicts enrollment in the PPO demonstration from its inception in January 2003 through August 2004.10 Beginning enrollment in the demonstration was about 53,000, most of which was due to the Horizon Healthcare of New Jersey contract (about 45,000 of the 53,000). Almost all of the initial Horizon enrollees transferred from a 2002 Horizon HMO product that was discontinued effective contract year 2003. For this reason, initial Horizon demonstration enrollment is more of a continuation of the earlier HMO enrollment than new enrollment attracted to a PPO product.11


Medicare preferred provider organization demonstration: plan offerings and beneficiary enrollment.

Pope GC, Greenwald L, Kautter J, Olmsted E, Mobley L - Health Care Financ Rev (2006)

Enrollment in the Preferred Provider Organization Demonstration: 2003-2004
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194956&req=5

f4-hcfr-27-3-095: Enrollment in the Preferred Provider Organization Demonstration: 2003-2004
Mentions: Figure 4 depicts enrollment in the PPO demonstration from its inception in January 2003 through August 2004.10 Beginning enrollment in the demonstration was about 53,000, most of which was due to the Horizon Healthcare of New Jersey contract (about 45,000 of the 53,000). Almost all of the initial Horizon enrollees transferred from a 2002 Horizon HMO product that was discontinued effective contract year 2003. For this reason, initial Horizon demonstration enrollment is more of a continuation of the earlier HMO enrollment than new enrollment attracted to a PPO product.11

Bottom Line: As preferred provider organizations (PPOs) become the dominant model of managed health care in the private sector, policymakers have increasingly viewed PPOs as an attractive option for Medicare.In part to understand how PPOs might operate under the Medicare Program, CMS launched the Medicare PPO demonstration in January 2003.In this article, we examine how PPOs have operated so far under the demonstration, including PPO availability and market entry; premiums, benefits, and beneficiary cost sharing; and enrollment, market share, enrollee characteristics, and disenrollment to date.

View Article: PubMed Central - PubMed

Affiliation: RTI International, Waltham, MA 02452, USA. gpope@rti.org

ABSTRACT
As preferred provider organizations (PPOs) become the dominant model of managed health care in the private sector, policymakers have increasingly viewed PPOs as an attractive option for Medicare. In part to understand how PPOs might operate under the Medicare Program, CMS launched the Medicare PPO demonstration in January 2003. In this article, we examine how PPOs have operated so far under the demonstration, including PPO availability and market entry; premiums, benefits, and beneficiary cost sharing; and enrollment, market share, enrollee characteristics, and disenrollment to date.

Show MeSH