title: Can managed care and competition control Medicare costs?
abstract: Medicare+Choice (M+C) was conceived to bring managed care and competitive forces to bear on Medicare. Ultimately, M+C could not thrive under the conditions of the marketplace and the Balanced Budget Act of 1997. Here I review what went wrong and the lessons from the experience, concluding that M+C is a tool, not a strategy. While managed care in a multiple-choice environment may have the potential to generate limited savings, promoting managed care and competition alone will not preempt the need for a debate on Medicare's obligations and how to finance them.
authors.affiliation: Mathematica Policy Research, Washington, DC, USA.
authors.forename: Marsha
authors.initials: M
authors.lastname: Gold
mesh_terms: D000368:Aged; D003363:Cost Control / Q000379:methods*; D004465:Economic Competition; D018588:Fee-for-Service Plans / Q000191:economics; D005249:Fees and Charges / Q000639:trends; D006279:Health Maintenance Organizations / Q000191:economics* / Q000706:statistics & numerical data; D006291:Health Policy / Q000191:economics*; D006297:Health Services Accessibility / Q000639:trends; D006801:Humans; D007342:Insurance Benefits / Q000639:trends; D020398:Medicare Part C / Q000191:economics* / Q000706:statistics & numerical data; D015397:Program Evaluation; D011907:Rate Setting and Review / Q000379:methods; D014481:United States