About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline
LOG IN
LOG IN

1 1 (August 25, 2022)

handle is hein.amenin/aeiaeki0001 and id is 1 raw text is: By Brian b Mtller, Ste ven C. Zrima, and Gal R, WVv ilensky August 2022 Op o l it' o_ g-q- -'a 41kp *--- i i-> ' ci^. gA o-$ surec-r cho_: '.._'hte e. -( h s E e tc-i ' s. ,- d- tcr~a e ier'1r -' - the '72 ' KECp nio~ >0 'T I!I q~'~->13-03! U -H a!-*- --JI c e -- 'C -` Lois --3!d .~ K I r riii Ie rb'hh; n a! :t ifletcvrii cae for e-itt-rob eicr e & .ia O- N C; NAi i-ing n INial' 20 percent ci national hTh care speing, or $t29.o billion anally, the M edicare prog&am continues to ev'v 2d' OigiNilly desigmled r tnance acute care character- ize-d by large, infrequent episodic costs, tradiional fe -for-sev ic f') Me 'icare has struggled r'ith the tran sition from covering the treatment of acute intfctious disease to a comcrehcnsive insurance progranm able to support the management o wide-- spread, chronic conditons, a model eharacterired by sustained o tlays due to trequent interaettons with care providers working together to help peo- pc achieve better health. Relying on a manstra-- tive price regulation, poaimakers have attenmpted to adapt Medicare's financing framnework by 'Ntr e- ducinig new payment frameworks such as p'rspec- tive paymer1cnt and episodic bundling for hospital care through diagnosis-reiated groups R)I risk corridor tied to quality ltries through the Merit-Based Incentive Payment System, and other toots that redistribute risk througihout the care delivery eosyster (igleihart 1983). The' Medicare Advantage (MA) pogram and its pee--cEsYrs represent ait tKe t transition thc Med'-Kre program aw-ay frnm ragentned 4 la carte F nFS Jmedine torard a c )or inated, integrated risk- bear ig care model t pl artn.ership with thie 11Th tscctr and the lipllteiei'ntation of man- aged car. Then A prgam s of nirther policysig- nificace s'ven >it strong focus on serving ianority populations and the econo micall d isa lvanitaged: Nearly oe th. d of Ml beneciares are raca ain-d -nicar min i> ties, and h aI' Caf all M ei--N p'ro iiriami beneficiaries have a.ual incornes beow $ 9,6?;em (M~urphy-Ba rroni et al. 20 >e; Koma 2,ON a)3 in this report, we briefly review the challe ges of risk transfer in the Medicare program and the evolution of .M'tA Special N eeds Plans (N-Ps) to meet the needs of unique populations of -Medicarc Oeneiciares, niotuing that SNP enrolles face even greater challenge-, '., 091 percent exhibting an incomc less than 200 percent of the federal poverty level nacobaon t, a Ve 2Z2d). Next, focusinE on cronic diseaise managemnt, NwCe xplore listori-al clialleniges N \ '~' ~ Customized Care for Complex Conditions

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.



Contact us for annual subscription options:

Contact Us

Already a HeinOnline Subscriber?

Log In

profiles profiles most