Savings estimate for a Medicare insured group.
Estimates of the savings potential of a managed-care program for a Medicare retiree population in Michigan under a hypothetical Medicare insured group (MIG) are presented in this article. In return for receiving an experience-rated capitation payment, a MIG would administer all Medicare and employer complementary benefits for its enrollees. A study of the financial and operational feasibility of implementing a MIG for retirees of a national corporation involving an analysis of 1986 claims data finds that selected managed-care initiatives implemented by a MIG would generate an annual savings of 3.8 percent of total (Medicare plus complementary) expenditures. Although savings are less than the 5 percent to be retained by Medicare, this finding illustrates the potential for savings from managed-care initiatives to Medicare generally and to MIGs elsewhere, where savings may be greater if constraints are less restrictive.
Birnbaum
H
H
Holland
S K
SK
Lenhart
G
G
Reilly
H L
HL
Hoffman
K
K
Pardo
D P
DP
D000368:Aged; D002204:Capitation Fee; D014487:Centers for Medicare and Medicaid Services, U.S.; D003363:Cost Control / Q000379:methods; D005240:Feasibility Studies; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D007221:Industry / Q000191:economics; D008329:Managed Care Programs / Q000191:economics*; D006278:Medicare / Q000458:organization & administration*; D008824:Michigan; D012179:Retirement / Q000191:economics*; D014481:United States