Resolving the tug-of-war between Medicare's national and local coverage.
Medicare's decentralized local coverage policy process leads to policy variation, raising serious equity and quality issues. The policy debate resembles a tug-of-war, with advocates favoring nationalization of all local policies or arguing for the status quo. We extensively analyzed thousands of local policies and surveyed Medicare's contractors. We found that all local policies are not the same. We classified them based on where they fall on the diffusion curve. The classification by type allows for reallocation to the national or local process to improve the decisions and satisfy Medicare's equity and quality goals.
Division of Health Services Research and Policy, University of Minnesota, School of Public Health, Minneapolis, USA.
Susan Bartlett
SB
Foote
Douglas
D
Wholey
Todd
T
Rockwood
Rachel
R
Halpern
D018166:Health Care Reform; D006297:Health Services Accessibility; D019458:Insurance Coverage; D006278:Medicare; D011787:Quality of Health Care; D012935:Social Justice; D014481:United States