Medicare risk contracting: analyzing managed care for the aging population in the USA.
This paper focuses on Medicare risk contracting in the USA. The issue of the current method of reimbursement versus Medicare risk contracting is explored. Risk sharing and payment mechanisms are described and analyzed. The strengths and weaknesses (score-card) of Medicare beneficiaries entering HMOs are reviewed. Finally, the issue of selection bias in Medicare HMOs is discussed regarding future implementation strategy.
Rivers
P A
PA
Graduate School of Management & Department of Health Services Administration, University of Alabama at Birmingham, USA.
Asubonteng
C A
CA
Bumpus
M
M
Munchus
G
G
D000368:Aged; D002204:Capitation Fee; D014487:Centers for Medicare and Medicaid Services, U.S.; D003284:Contract Services; D006279:Health Maintenance Organizations / Q000191:economics*; D006801:Humans; D007255:Information Services; D006278:Medicare / Q000191:economics / Q000458:organization & administration*; D012051:Reimbursement Mechanisms; D020414:Risk Sharing, Financial; D015983:Selection Bias; D013659:Tax Equity and Fiscal Responsibility Act; D014481:United States