title: Nothing for something? Estimating cost and value for beneficiaries from recent medicare spending increases on HMO payments and drug benefits.
abstract: The Medicare Modernization Act of 2003 added a new outpatient prescription drug benefit to Medicare and increased payments to HMOs. We estimate a nested logit model of plan choice to quantify the welfare benefits from these two expansion paths. We find that the addition of stand-alone prescription drug plans was welfare improving and produced nine times as much value per government dollar as the increase in payments to HMOs. In light of these results, we suggest that HMO bidding procedures should be modified to reduce payments to HMOs by about $67 billion over the next 10 years.
authors.affiliation: Department of Veterans' Affairs, Health Care Financing & Economics, VA Boston Health Care System, Boston, MA 02130, USA. pizer@bu.edu
authors.forename: Steven D
authors.initials: SD
authors.lastname: Pizer
authors.forename: Austin B
authors.initials: AB
authors.lastname: Frakt
authors.forename: Roger
authors.initials: R
authors.lastname: Feldman
mesh_terms: D002755:Choice Behavior; D003164:Competitive Bidding; D005380:Financing, Government / Q000191:economics; D006279:Health Maintenance Organizations / Q000191:economics*; D019458:Insurance Coverage; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D006278:Medicare / Q000191:economics* / Q000331:legislation & jurisprudence; D008962:Models, Theoretical; D010045:Outpatients; D014481:United States