Medicare Coverage
The Future of Private Plan Contracting in Medicare
Research Report
Robert A. Berenson, AARP Public Policy Institute
Bryan E. Dowd, Ph.D, University of Minnesota
July 2002
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"Medicare has contracted with private health plans to provide services to enrolled beneficiaries almost from its inception. Most typically, these plans have been health maintenance organizations (HMOs), although since the enactment of the Balanced Budget Act of 1997, Congress has signaled its desire for a broader range of private plan options, including preferred provider organizations (PPOs), private fee-for-service plans, and medical savings accounts (MSAs). Therefore, it is likely that private health plans will continue to play a role in providing services to a portion of the beneficiary population in the future."
—from the foreword by Joyce Dubow to the AARP Public Policy Institute Issue Paper in which Robert A. Berenson and Bryan E. Dowd examine the goals and objectives of Medicare contracting with private health plans (such as HMOs and PPOs), provide a general framework for considering various payment approaches, and explore the implications for future contracting of choosing one of these approaches over another. (52 pages)
Pub ID: 2002-12